Comparison Of Pure Mucinous With Mixed Mucinous Breast Carcinoma Based On Clinical Characteristics And Treatment

Objective: The purpose of this study was to retrospect the overall course of PMBC and MMBC for prospecting MBC status and guiding clinical treatment in term of clinicalcharacteristics,treatment results,survival prognosis and other aspects.Methods: 70 patients with histological diagnosis of primary Mucinous Carcinoma were selected in the Dalian municipal central hospital from January 1997 to December 2012 according to study criteria.ALL the 70 patients were experienced clinical inspection of breast ultrasound,mammography,X-ray,etc for the breast neoplasm evaluation.And all the histological slices were rechecked for pathological demonstration according to the World health Organization standards.The cancer TNM staging is divided by American Joint Committee on Cancer Staging(AJCC),and the NICC is used to be the guidance standards of the surgery and the treatment which was carried out in the Dalian municipal central hospital.These postoperative adjuvant therapies include chemotherapy,radiation therapy,endocrine therapy,anti-Her2 targeted therapy and Immunity enhancement,etc.All the clinical examination,treatment approaches and prognosis had been analyzed comprehensively for MBC clinical treatment guidance and prognosis prediction SPSS software(version 13.0)was used for all of the statistical analysis.Results: 1.The clinical data of the PMBC and MMBC showed that all the patients were postmenopausal.The average age was over 65.The data analysis of PMBC and MMBC were as follows respectively: I-II TNM stage patients(89.1% and 83.3%),p N0(89.1%and 69.2%),ER receptor(86.9% and 76.9%),and PR receptor(82.6% and 75%,Her-2receptor(65.2% and 41.7%).The data indicated that PMBC and MMBC patients showed no significant differences in age,TNM stage,tumor size and hormone receptor status(estrogen or progesterone receptors),P>0.05.But the axillary lymph node metastasis rate of MMBC patients was obviously higher than that of PMBC patients,P< 0.05.And the Her-2 receptor expression in MMBC patients was significantly lower than that of PMBC patients,P < 0.05.2.Surgery was operated to all the patients.Among which 10(21.7%)PMBC patients and 5(20.8%)MMBC patients had experienced the modified radical mastectomy,while 36(78.3%)PMBC patients and 19(79.2%)MMBC patients underwent BCS.There were 7(15.2%)PMBC patients and 6(25%)MMBC patients received chemotherapy.There were 34(73.9%)PMBC patients and 19(79.2%)MMBC patients underwent endocrine therapy.There were 19(41.3%)PMBC patients and14(58.3%)MMBC patients experienced radiotherapy.There were 28(60.9%)PMBC patients and 6(25%)MMBC patients selected anti-Her2 targeted therapy.The data showed that the two groups expressed no significant differences in treatment of surgery,chemotherapy,radiotherapy and endocrine therapy,P>0.05.And status of patients demonstrated obvious advantages in postoperative targeted therapy,P<0.05.3.The five years DFS rate of PMBC patients and MMBC patients were: 94%and 71% respectively,the five years OS rate of PMBC patients and MMBC patients were: 96% and 79% respectively.Patients with PMBC has a signi?cantly better prognosis than that of MMBC,P<0.05.4.The data showed that these elements had no significant effect in the five years DFS rate of PMBC,which were patient’s age,TNM stage,expression of ER,expression of PR,operation methods,radiotherapy,chemotherapy and endocrine therapy.But the axillary lymph node metastasis and anti-Her2 targeted therapy had effects on five years DFS rate in PMBC.And the data indicated that these factors had no effect in the five years DFS rate in MMBC,which were patient’s age,TNM stage,expression of ER,expression of PR,operation methods,radiotherapy,chemotherapy and anti-Her2 targeted therapy.But the axillary lymph node metastasis and endocrine therapy had effects on five years DFS rate in MMBC.5.All the patients were followed up for five years at least or until death.The average period of follow-up is 60 months calculating from the surgery date.Ten patients(3 PMBC and 7 MMBC)turned out to have metastasis and recurrence.The observations showed that recurrence and distant metastases were the main cause of treatment failure in both the presented groups.Conclusion: The prognosis of PMBC patients was better than that of MMBC patients and the incidence of the axillary lymph node metastasis was lower than that of MMBC patients,other clinical characteristics had no significant difference between the PMBC and MMBC patients,and the anti-Her2 targeted therapy had obvious advantages on prognosis.