Relationship Between Clinicopathological Features And Radiotherapy Efficacy Of Different Molecular Subtypes Of Breast Cancer

Objective: To observe the clinical characteristics and expression of invasive breast cancer with different molecular subtypes.Exploring the correlation between radiotherapy effect and prognosis of different molecular subtypes of breast cancer after modifying radical mastectomy.Methods: The 295 specimens of invasive breast cancer after modified radical mastectomy were collected from the Fourth Hospital of Hebei Medical University from January to August 2015,including 244 cases of invasive ductal carcinoma of the breast,18 cases of invasive lobular carcinoma,and 6 cases of mucinous adenocarcinoma.4 cases of cancer,23 cases of other types.Analysis of differences in age,T stage,lymph node metastasis,tumor size,clinical stage and prognosis of various molecular subtypes of breast cancer patients and factors affecting prognosis.The effects of radiotherapy on local recurrence rate,distant metastasis rate and tumor-free survival rate of 4 groups of molecular subtype breast cancer patients were compared.SPSS 22.0 statistical software was used to analyze the relationship between modified radical mastectomy and clinicopathological features and prognosis,and multivariate analysis was performed.Result: Molecular typing of breast cancer patients,49 cases of Luminal A(16.6%),200 cases of Luminal B(67.8%),7 cases of Her-2 overexpression(2.4%),and 39 cases of Basal-like type(13.2 %).1.Molecular typing of breast cancer patients was related to radiotherapy(χ2=18.326,P<0.05).Univariate analysis showed that there was no correlation between the molecular typing of breast cancer patients in age,tumor maximum diameter,T stage,clinical stage,chemotherapy,lymph node metastasis(P>0.05).Among the 295 patients who were followed up,the local recurrence rate(28.6%)of Her-2 overexpressing breast cancer patients was higher than other subtypes(χ2=8.804,P=0.032).129 cases were metastasized in the distance.The test results showed that the molecular typing of breast cancer patients was not statistically significant(χ2= 5.901,P = 0.117).3.Radiotherapy in Luminal A,Luminal B and Basal-like patients reduced the local recurrence rate(χ2=5.575,P=0.018,χ2=36.04,P<0.05,χ2=18.822,P<0.05).And the distant metastasis rate of Luminal B-type and Basal-like radiotherapy patients(χ2=108.234,P<0.05,χ2=4.496,P=0.034)and tumor-free survival rate(χ2=25.032,P<0.05,χ2= 4.932,P=0.026)was statistically significant compared to patients without radiotherapy.However,the tumor-free survival rate of Her-2 type and radiotherapy had no effect on the distant metastasis rate and tumor-free survival rate of Her-2 type and Luminal type A patients(P>0.05).4.There was no significant difference in the 1-year and 3-year OS(P>0.05)of breast cancer patients with different molecular subtypes.5.Univariate analysis of the patient’s age,lymph node metastasis and molecular typing showed that lymph node metastasis and molecular typing were important factors affecting the patient’s 3-year OS(P < 0.05).6.Multivariate Cox regression analysis: Lymph node metastasis status and molecular typing were independent factors affecting patients with DFS and OS(P<0.05).The results showed that the prognosis of Her-2 overexpression was poor,and the difference was statistically significant(P <0.05).Conclusion:1.Molecular typing of breast cancer patients is related to radiotherapy.2.The local recurrence rate of Her-2 overexpressing breast cancer patients is higher than other subtypes.3.Radiotherapy reduced the local recurrence rate of patients with Basal-like,Luminal B and Luminal A and the distant metastasis rate and tumor-free survival rate of Luminal B and Basal-like radiotherapy patients.4.Lymph node metastasis status and molecular subtypes are independent factors affecting patients with DFS and OS.Her-2 overexpression has a poor prognosis.