Clinicopathological Features And Prognosis Of Breast Invasive Ductal Carcinoma With Low HER-2 Expression

Objective:To investigate the clinicopathological characteristics and prognosis of patients with low expression of human epidermal growth factor receptor 2(HER-2)in infiltrating ductal carcinoma(IDC)of breast.To analyze the independent factors affecting the prognosis of breast cancer patients with HER-2 low expression.Methods:Patients diagnosed with invasive ductal carcinoma of the breast after 292 routine surgical treatments from January 2015 to June 2019 in the First Affiliated Hospital of Gannan Medical College were selected as study subjects.Clinical data and histopathological data of the patients were collected.All patients were followed up until June 2022 after corresponding treatment postoperatively.To compare the clinicopathological characteristics as well as the 3-year disease-free and overall survival rates between breast cancer patients with different HER-2 status,Cox multivariate analysis was performed to identify the independent factors affecting the disease-free and overall survival rates of breast cancer patients with low HER-2expression.Results:1.In this study,93 breast cancer patients with HER-2 low expression were included,accounting for 31.8% of the breast cancer patients included in the study during the same period.There were 18 patients with Hormone receptor(HR)negative and HER-2 low expression,accounting for 17.3% of HR-negative breast cancer patients in the same period.75 patients with HR positive and HER-2 low expression accounted for 39.9% of HR-positive breast cancer patients in the same period.The proportion of HR positive in patients with low HER-2 expression was higher than that in patients with HER-2 negative and HER-2 positive(p<0.05).2.In all patients,there were no significant differences in age,menstrual status,tumor T stage,lymph node metastasis,Ki-67 expression,histological grade and TNM stage among the HER-2 low expression group,HER-2 negative group and HER-2positive group(p>0.05).In HR-negative breast cancer patients,there were no significant differences in age,menstrual status,tumor T stage,lymph node metastasis,Ki-67 expression,histological grade and TNM stage among the above three groups(p>0.05).Whereas in HR-positive breast cancer patients,Ki-67 expression in HER-2low expression and HER-2 positive patients is higher than that in HER-2 negative patients(p<0.05).In relapsed and metastatic patients,there were no significant differences in tumor T stage,lymph node metastasis,histological grade and TNM stage among the HER-2 low expression group,HER-2 negative group and HER-2positive groups(p>0.05),the age of initial tumor onset in HER-2 low expression patients was lower than that in HER-2 negative and HER-2 positive patients,compared with HER-2 negative patients(p<0.05),HER-2 low expression patients are more likely to have tumor recurrence and metastasis in premenopausal patients at the time of tumor onset(p<0.05).3.No matter the patients with HR positive or HR negative,there were no significantly differences in 3-year disease-free survival rate and total survival rate among the three groups of HER-2 negative,HER-2 low expression and HER-2overexpression(p>0.05).Multivariate analysis showed that TNM stage was an independent factor affecting the disease-free survival rate of patients with low HER-2expression(p<0.05).Age,menstrual status,tumor T stage,lymph node metastasis,histological grade,Ki-67 expression are not independent factors that affect disease-free survival and overall survival of breast cancer patients with HER-2 low expression(p>0.05).Conclusions:1.In breast cancer patients with HER-2 low expression,HR positive ratio is higher than HER-2 negative and HER-2 positive patients.2.In HR positive breast cancer patients,Ki-67 expression in HER-2 low expression and HER-2 positive patients is higher than that in HER-2 negative patients.Among the patients with recurrence and metastasis,the age of initial tumor onset in HER-2 low expression patients was lower than that in HER-2 negative and HER-2positive patients,compared with HER-2 negative patients,HER-2 low expression patients are more likely to have tumor recurrence and metastasis in premenopausal patients at the time of tumor onset.3.TNM stage is an independent factor affecting disease-free survival rate of breast cancer patients with HER-2 low expression.