Molecular Subtypes Of Breast Cancer With Clinicopathological Features And Prognosis

Objective: To explore the relationship between breast cancer molecularsubtypes and prognosis for better clinical individualized treatment.Method: From January2004to December2007, clinical and pathologicaldata of operable female breast cancer patiens in our hospital wereretrospectively analyzed. In all of513cases,the age was between29-83,with amean age of47years old. According to the estrogen receptor (ER), progesteronereceptor (PR), human epidermal growth factor receptor2(HER-2) status andhistological grade,all of513breast cancer patiens were classified into fourdifferent molecular subtypes: Luminal A, Luminal B, HER-2over-expressionand basal like. The distribution of breast cancer molecular subtypes in patientsand the correlation between clinicopathological characteristics and molecularsubtypes were comparatively analyzed. Kaplan-Meier survival analyses andCOX proportional-hazards regression were used to identify the prognosissignificance of the different molecular subtypes.Result: Of513cases,follow-up period was7~109months and median follow-up period was57months. Luminal A were the majority，300cases(58.5%)，Luminal B、Basal like and HER-2overexpression were114cases(22.2%)、62cases (12.1%) and37cases (7.2%) respectively. There was nostatistical difference between breast cancer molecular subtypes and age,menopausal status, family history, tumor size, pathologic type, surgicalapproaches. The molecular subtypes differed significantly in lymph node status,histologic grade, ER status, PR status, HER-2status, the AJCC stage, adjuvantchemotherapy, radiotherapy and endocrine therapy. Overall survival of differentmolecular subtypes were significantly different (P <0.05).Luminal A subtypehad a better prognosis than the other three types, HER-2over-expressingsubtype was the worst. Univariate analysis showed that age, menopausal status,T stage, lymph node status, histological grade, AJCC stage,molecularsubtype,radiotherapy,endocrine therapy,the ecurrence/metastasis affected theoverall survival of breast cancer. Multivariate analysis revealed that age, lymphnode status, AJCC stage, molecular subtype and recurrence/metastasis wereindependent prognostic factors for overall survival of breast cancer.Conclusion: The molecular subtypes are closely related to clinicaloutcomes and better reflect the biological behavior of breast cancer,which willbe useful for guiding clinical individualized treatment options.