| Objective: To investigate the correlation between molecular typing and clinicopathological characteristics,and study its prognostic value in young breast cancer patients.Methods: A total of 198 young breast cancer patients aged less than 35 years old who underwent surgery in our department between Jan 2008 to Dec 2009 were retrospectively studied.Among them,171 patients could be retrieved for their follow up data and thus enrolled in the current study.According to St.Gallen Consensus,the patients were catogrized into 4 molecular types based on immunohistochemistry stain of 4 markers,as follows: Luminal A:[ER(+)/PR(+)and HER2(-)and Ki-67 <14%];Luminal B: including Luminal B-1: [ER(+)/PR(+)and HER2(-)Ki67≥ 14%] and Luminal B-2: [ER(+)/PR(+),HER2(+)];HER2(+): [ER(-)and PR(-)and HER2(+)];triple negative: [ER(-)and PR(-)and HER2(-)].Analyze the difference of clinicopatholgical factors among various of molecular subtypes,such as age,tumor size,histological type,axillary lymph node metastasis,clinical TNM stage,histological grade,operation mode,adjuvant therapy and other aspects.All patients were followed up from the day after surgery,the follow-up data was collected in January 2015,and the median follow-up duration was 65 months.The survival of the patients was analyzed,and the difference of the prognosis and the influencing factors were discussed.The statistical analysis of the research was done by SPSS19.0,the clinicaopathological features of distribution differences between the various subtypes by t text or χ2 test,survival curves by the Kaplan-Meier survival analysis,the difference in survival between groups was compared by Log rank test,χ2 test for univariate analysis,the Cox model for multivariate survival analysis,a significant level of test was defined as P <0.05,two sides.Results: The median age was 31.5 years old in serise of 171 cases.The vast majority of pathological type was invasive ductal carcinoma 155(90.6%),other patholgical types include invasive lobular carcinoma 8(4.7%)and specific types of caner 8(4.7%)such as medullary carcinoma,mucinous carcinoma etc.By immunohistological stain sub-typing,we confirmed Luminal A,Luminal B,HER-2(+)and triple negative in 70(40.9%)39(22.8%)14(8.2%)48(28.1%),respectively.There were no statistically differences among 4 molecular types regarding age,pathological type,tumor size,clinical stage,axillary lymph node metastasis,histological grade,operation mode and radiotherapy(P>0.05).There were statistically differences in endocrine therapy and chemotherapy.Luminal type patients with hormone receptor positive can benefit from endocrine therapy,thus most of them received endocrine therapy in comparison to HER-2 or triple-negative subtype(P<0.05).The 5-year overall survival rates for the 4 subgroups were 85.7%,82.1%,71.4%,66.7% respectively,which was significant different(P<0.05).Univariate analysis showed that clinical stage,molecular typing,tumor size,axillary lymph node metastasis,histological grade and endocrine therapy were statistically significant(P<0.05),Cox multivariate analysis showed molecular subtypes,axillary lymph node metastasis and histological grade were independent prognostic factors.Conclusion:(1).The young breast cancer patients biological behavior is more invasive,with more triple-negative subtype.Luminal A type showed a favorable survival comparing to other subtypes.While the triple-negative subtype was the worst with much higher risk of recurrence and metastasis.Young breast cancer molecular typing had significant difference in the acceptance of chemotherapy(2).Molecular typing,axillary lymph node metastasis,histological grade were independent prognostic factors for survival in young breast cancer patients. |
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