The Study Of Tumors Shrinkage Mode After Neoadjuvant Chemotherapy In Breast Cancer

Objective The aims of our study is to observe tumors shrinkage mode after neoadjuvant chemotherapy by whole-mount serial section after breast cancer surgery,and to explore the factors which related to tumors shrinkage mode,so that to help guiding the selection of breast surgery.Methods 56 cases of pathologically proven invasive ductal carcinoma(?A-?C)were collected in the breast disease health center of the Affiliated Hospital of Qingdao University from December 2015 to January 2017.Breast specimens were prepared with PMSS.Residual tumors were microscopically outlined,and the shrinkage mode were evaluated which were divided into pathological complete remission(p CR),concentric shrinkage,non-concentric shrinkage and no significant shrinkage.Find out the patients who have the clinical efficacy evaluation of effective(c CR+c PR),and also have clear shrinkage mode,then analyze the relationship between types of tumors shrinkage and the patient's age,menstrual status,BMI,chemotherapy regimen,primary tumor T stage,ultrasound manifestations(mass-like and non-mass-like),Mammography(Calcification,glitch),immunohistochemistry characteristics(ER,PR,HER-2,Ki67),and molecular types.Results The tumors shrinkage mode of 40 paitents who meet the conditions were not related to the patient's age,menstrual status,BMI,chemotherapy regimen,immunohistochemistry characteristics(ER,PR,HER-2,Ki67),and molecular types.There was a significant difference between the mass-like and non-mass-like type and the tumors shrinkage model(P <0.05).The percentage of concentric shrinkage model were 30.77% and the percentage of non-concentric shrinkage model were 69.23% in non-mass-like type patients.The percentage of concentric shrinkage model were 70.37% and the percentage of non-concentric shrinkage model were 29.63% in mass-like type patients.There was a significant difference between the primary tumor T stage and the tumors shrinkage(P <0.05),T1 stage have one patient was concentric shrinkage model.73.91% of the patients with T2 have concentric shrinkage model,and 26.09% of them have non-concentric shrinkage model.35.71% of the patients with T3 have concentric shrinkage model,and 64.29% of them were non-concentric shrinkage model.T4 have 2 patients were non-concentric shrinkage model.There was a significant difference between malignant calcification and the tumors shrinkage(P <0.05).There were 43.48% patients with malignant calcification and 56.52% without malignant calcification in concentric shrinkage model.There were 82.35% with malignant calcification and 17.65% without malignant calcification in non-concentric shrinkage model.Conclusion The tumor shrinkage model of neoadjuvant chemotherapy in breast cancer was correlated with ultrasonography(mass-like and non-mass-like type),malignant calcification and primary tumor T stage.To a certain extent,we can predict the the tumor shrinkage model before chemotherapy,and predict the feasibility of breast conserving surgery.