| Objective:Analyze the clinicopathological features of breast cancer patients of70years or older, and compare the efficacy of different treatment options, in order to provide a theoretical basis for the clinical individualized treatment.Methods:Collect80cases of breast cancer patients of70years or older in Shan Dong province hospital from June2003to June2007and analyze the pathological types. Choose72cases of all, which are the type of infiltrating ductal breast cancer, and analyze the clinicopathological features. According to the inclusion criteria, I choose67cases of all the infiltrating ductal breast cancers and divide them into three groups, group A, group B, and group C(group A:modified radical mastectomy+chemotherapy+endocrine therapy; group B:modified radical mastectomy+endocrine therapy; group C:breast mass excision+endocrine therapy). The postoperative recovery of the patients is evaluated by the common indicators, which are observed in the clinical treatment, and I introduce cancer treatment of functional evaluation system to evaluate the quality of life of the patients after the patients are treated by the three programs, and I also use the Kaplan-Meier method to calculate the overall survival rate(OS) and the disease-free survival rate(DFS). I use the Kaplan-Meier method to compare the overall survival rate and the disease-free survival between group A and group B, and also do the Log-Rank test, and the same thing is done between group B and group C. Inspection level α=0.05. Results:Of all the80cases of the elderly breast cancer patients, there are42cases(52.5%) who are associated with other diseases, and the pathological type is mainly invasive ductal carcinoma, which accounts for90%. There are5cases in stage Ⅰ, accounting for6.6%. There are39cases in stage Ⅱ, accounting for62.7%. There are28cases in stage Ⅲ, accounting for30.7%. I analyze the factors and find that there is correlation between the number of lymph node’ metastasis and the tumor size (P<0.001). I analyze the Immunohistochemistry and find that ER-positive in52cases, accounting for72.2%and PR-positive in45cases, accounting for62.5%, and the ER and PR positive rate is higher in the elderly breast cancer patients. I study67cases of all and find that there are39cases in stage Ⅱ,7cases are in group A, which accounts for17.9%, and20cases are in group B, which accounts for51.3%, and12cases in group C, which accounts30.8%. There are28cases in stage Ⅲ, and6cases in group A, which accounts for21.4%, and12cases in group B, which accounts for42.9%, and10cases in group C, which accounts for35.7%. Compared with group B and C, the time of stitches and moving the drainage tube is prolonged for the patients in group A, and there also are a high rate of skin flap necrosis and subcutaneous fluid. However, there are no cases, who suffer flap necrosis and subcutaneous fluid in group C, and the shortest time for stitches and moving the drainage tube is respectively the3rd day and the7th day, and the effect of group B is between group A and group C. The patients in group A are not satisfied with the physical function, social and family relation, physical condition and emotion, meanwhile the patients in group C are more satisfied with the physical function, social and family relation, physical condition and emotion. The evaluation of patients in group B is between group A and group C. Stage Ⅱ:I analyze the3years,5years overall survival rate in group A and group B and find that there is no statistical significance in group A and group B (P=0.684), and there is also no statistical significance when analyzing the3years,5years disease-free survival rate (P=0.665). I also analyze the3years,5years overall survival rate in group B and group C and find that there is no statistical significance in group B and group C (P=0.906), and there is also no statistical significance when analyzing the 3years,5years disease-free survival rate (P=0.648). Stage Ⅲ:I analyze the3years,5years overall survival rate in group A and group B and find that there is no statistical significance in group A and group B (P=0.759), and there is also no statistical significance when analyzing the3years,5years disease-free survival rate (P=0.809). I also analyze the3years,5years overall survival rate in group B and group C and find that there is no statistical significance in group B and group C (P=0.431), and there is also no statistical significance when analyzing the3years,5years disease-free survival rate(P=0.691).Conclusion:(1) The invasive ductal carcinoma is the most common clinical pathology type in the elderly breast cancer, and the tumor size is mostly in T2, which accounts for44.4%and the lymph node staging is mostly in NO, which accounts for44.4%, and most cases is in stage Ⅱ, which accounts for62.7%.(2) There is correlation between the tumor size and the number of the lymph node’metastasis.(3) The rate of estrogen receptor positive and progesterone receptor positive is high in the elderly breast cancer patients.(4) The study suggests that the surgical methods and chemotherapy don’t improve the3years,5years OS and DFS in the ER/PR positive breast cancer patients of70years or older. The postoperative recovery of the patients who suffer chemotherapy is slow, and the elderly patients aren’t satisfied with the quality of life after chemotherapy. |
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