Differences Of Bioindicators Between Preoprative Core Needle Biopsy And Postoperative Excisional Biopsy Of Breast Cancer

Backgrounds:Along with the speedy boom of scientific research and technologic concepts,the diagnosis of breast cancer tends to ever-swelling maturity.The year of 2018 witnessed new breast cancer patients occupied 10%of total cancer patients around the world.Under such circumstance,breast carcinoma is still the most important factor to threaten the health of females.Nowadays,following the increasing cognition of an individually multidisciplinary and comprehensive pattern,the treatments like neoadjuvant chemotherapy and endocrinotherapy become prevailing.Most researchers think that NAC and preoperative endocrinotherapy can have an influence on the expression of bioindicators of breast cancer.Some research said that patients who got pathological complete remission from NAC were easier to achieve longer disease-free survival and overall survival,comparing with those who didn’ t get.For the application of locally advanced breast carcinoma,NAC can not only decrease the size of tumor,but control the micrometastasis.During this period,it depends on core needle biopsy to select the way of preoperative treatment.However,they are heated debate over whether CNB is reliable,how to choose the ideal chemotherapy program and so on.So they’ re significant to study in accuracy of CNB and differences between pre-NAC and post-NAC.Objective:The article is aimed at comparing and analyzing the differences in explicitation of immunohistochemistry between preoperative CNB and excisional biopsy.We debate over whether the pathological results CNB gets can represent the primary lesion and the differences occur after NAC in order to predict the efficacy of NAC and maximize the therapeutic effects for breast malignant tumor.Materical and methods:During the past period ranging from January 2015 to December 2018,a retrospective review of 154 breast cancer patients who got CNB and excisional biopsy in Shandong University Qilu hospital.An aggregation of patients’ clinical information,explicitation of preoperative and postoperative immunohistochemistry,the chemotherapy regimens are collected.With the statistical analysis,accuracy of CNB and differences between pre-NAC and post-NAC affecting NAC’ s efficacy can be obviously witnessed.Results:1.172 breast cancer patients were adopted in the statistical analysis.All of them received CNB before getting modified radical mastectomy or radical mastectomy.They were unilateral breast cancer patients,aging from 27-70 years old.The average age was 47.2 years old.There were 82 cases of left breast cancer,while 90 of right.After CNB therapy,the percentage of population who got NAC was 79.07%.87 patients got neoadjuvant chemotherapy regimens as ET.49 patients got neoadjuvant chemotherapy regimens as TEC.The family members of 2 cases had the malignant tumor.2.For the patients who got preoperative CNB without NAC,the differences still existed between preoperation and postoperation.But there was no significant meaning of the changing rates(27.78,%of ER,22.22%of PR,38.89%of HER-2,44.44%of Ki-67,38.89%of P53,P>0.05).3.There was change from pre-NAC to post-NAC of biological indicators.The changing rates were 40.23%of ER,40.23%of PR,48.28%of HER-2,89.66%of Ki-67,54.02%of P53,which belonged to the patients provided ET as neoadjuvant chemotherapy treatment.The changing rates were 32.65%of ER,46.94%of PR,34.69%of HER-2,81.63%of Ki-67,51.02%of P53,which belonged to the patients provided TEC as neoadjuvant chemotherapy treatment.The neoadjuvant chemotherapy could have influence on expression of biological indicator,but there was no significant statistics meaning for the change of ER,PR,HER-2 and P53(P>0.05).After neoadjuvant chemotherapy,the trend of Ki-67 dramatically decreased,which had the significant statistics meaning(P<0.05).But the difference of changing rates had no significant meaning(P>0.05).4.The descending trend of Ki-67 was tightly related to MP classification(P<0.05).There was no significant difference among diverse chemotherapy regimens(P>0.05).Conclusion:1.The immunohistochemistry of pre-operative CNB could accurately reflect biological characteristics of breast cancer.CNB was reliable for the early diagnosis.2.After the neoadjuvant chemotherapy,all of biological indicators had changed but only index of Ki-67 significantly decreased,which was correlated well with pathological MP classification(P<0.05)Nonetheless,there was rarely significant difference between ET and TEC neoadjuvant chemotherapy regimens.The trend of Ki-67 might be likely to become an independent predicted factor for neoadjuvant chemotherapy.3.Among molecular subtypings,there was no obvious difference between pre-NAC and post-NAC.4.The change occurred in biological indicators because of neoadjuvant chemotherapy treatment,contributing to maximize the therapeutic effects for breast malignant tumor and form individual therapeutic regimen.