The Different Molecular Subtypes, The Biological Parameters And Adjuvant Therapies Associated With Prognosis Of Chinese Elderly Breast Cancer Patients

[Abstract] Objective:This study aims to analyze four molecular subtypes of breast cancer in Chinese elderly patients, which relate prognostic factors about recurrence and metastasis as well as the adjuvant therapy.Materials and Methods:There are 374 Chinese elderly breast cancer patients involved in the retrospective analysis from Jan,2000 to Jan 2009 in our hospital. After a median 57.2 months follow-up, we find that different molecular subtypes have their different trend peak of recurrence and metastasis. With the relevant biological parameters, for example, Ki67, CK5/6, EGFR, VEGF, the recurrence and metastasis are independent on the efficacy of adjuvant chemotherapy, radiation and endocrine therapy.Result:The major subtypes of Chinese elderly breast cancer patients are Luminal A and Luminal B. The Basal-like and HER-2 over-expression patients have poorer prognosis than Luminal A and Luminal B type patients as well as higher risk of recurrence and metastasis. The difference is independent on tumor size (RR=2.73,95%CI2-3.16), lymph nodes (RR=2.01,95%CI1.27-2.33) and the biomarkers for example Ki67, CK5/6, EGFR, VEGF etc. It shows different trend peak of the recurrence risk between the different subtypes, especially in the Ki67 positive group. Adjuvant therapy for elderly breast cancer patients has some limitation because of systemic diseases and other constraints to a certain extent offset, but there is statistically significant difference in the adjuvant chemotherapy for basal-like and HER-2 over-expression patients.Conclusions:It's totally different proportion of molecular subtypes in Chinese elderly breast cancer tumors from that in young patients. The molecular subtypes are based on the histopathological traits, which are taken as prognostic factors such as Ki67. The prognosis is not only influenced by the adjuvant therapy but also by the age and systemic diseases of the elderly women, because patients are so elderly that they will suffer from other non-breast cancer mortality factors. These are the limitations of this study. To a certain extent, the results still show that the adjuvant therapy play an important role in the prognosis.