| Objective: To explore the differences in clinicopathological characteristics and prognosis of young breast cancer with different molecular subtypes,we started this study,and in order to analyze the factors that affect the prognosis of young breast cancer patients.What we do also provide guidance for clinical diagnosis and treatment.Methods: A total of 81 female patients with breast cancer have treated in our hospital from January to December in 2007.01-2011.06 were enrolled in this study.The criteria were as follows: primary breast cancer,complete pathologic findings(including immunohistochemistry)and complete clinical data.Excluding patients express HER-2 to the extent 2+ while was not detected with FISH.The clinical and pathological data were collected,including age,menstrual status,tumor size,axillary lymph node metastasis,family history of malignant tumor,ER,PR,HER-2 expression,surgery,recurrence and metastasis and survival status.Follow up to May 2016,compared with different molecular types of young breast cancer patients 5 years DFS and between the differences between the OS.Finally,the prognostic factors of young breast cancer were obtained which was about 5-years of DFS and OS.Results: In the collected cases,the age range of the patients was 18-35 years old,the median age was 31.2 years old,and the symptoms of the patients ranged from 1 days to 5 years,with an average of about 5 months.Among the selected cases,24 patients had a family history of malignant tumor.All patients underwent surgical treatment,and pathological results were confirmed by pathology in our hospital.There were 14 cases in stage I,37 cases in stage,28 cases in stage III and 2 cases in stage IV.According to the results of immunohistochemistry,the proportion of three negative type was higher.Three negative type breast cancer recurrence and metastasis rate higher than other molecular subtypes.The difference was statistically significant,P < 0.05.There were no significant differences in the distribution of age,family history of tumor,tumor diameter,number of lymph nodes,pathological type,TNM stage and so on.The overall survival rate of Luminal type was significantly higher than that of Her-2 overexpression and basal-like breast cancer.Luminal type DFS was 47.7%,HER-2 over expression type DFS was 41.9%,and triple negative subtype DFS was 36.6%,no significant difference between three groups(P > 0.05).The primary site of metastasis was the most common bone metastasis in young breast cancer.The results of univariate analysis showed that HER-2 status,tumor size,number of lymph node metastasis is related to factors of 5-year breast cancer-specific PFS rates for young patients;the maximum tumor diameter,lymph node metastasis,TNM staging is related to factors affecting the 5-year breast cancer-specific OS rates for young patients.Multivariate COX regression analysis showed that the maximum tumor diameter and lymph node metastasis were independent prognostic factors of PFS and OS.Conclusion: 1.Young breast cancer has a unique clinical and pathological features,the molecular classification of the most common subtype of negative type of three,which is more prone to recurrence and metastasis.2.The 5 year OS of Luminal subtype was significantly higher than that of Her-2 overexpression and triple negative subtype breast cancer.Tumor size and lymph node metastasis were the main factors affecting the prognosis.3.More attention should be paid to early diagnosis and comprehensive treatment of young patients with breast cancer in order to improve the prognosis. |
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