| BackgroundBreast cancer is one of the common malignant tumors that endanger women's health worldwide.The latest statistics released in CA magazine in 2017 show that breast cancer ranks first in the incidence of female malignancy.In recent years,with the development of screening for breast cancer,the rapid development of medical imaging,the widespread application of new technologies,and the significant improvement in the diagnosis and treatment of malignant tumors,the detection rate of clinically nonpalpable breast lesions(NPBL)has gradually increased.Nonpalpable breast cancer(NPBC)refers to the physical examination can not reach a significant mass,only through breast Color Doppler ultrasound,Mammography,Ductoscopy,MRI and other auxiliary examination found lesions,and pathological examination confirmed breast cancer.It has been reported that NPBC has unique biological behavior and needs further research to confirm.Breast cancer is a type of malignant tumor that has a high degree of heterogeneity at the molecular level.Tumors with the same clinicopathological features can exhibit different biological behaviors.The treatment of breast cancer has progressed from the tumor stage to the immunohistochemical phenotype to molecular pathological diagnosis.Modern breast cancer treatment has entered the age of classification and treatment based on molecular typing.Breast cancer can be divided into Luminal A,Luminal B,HER-2 overexpression and Basal-like.Each subtype has its specific tumor biological characteristics.Patients with different subtypes have different therapeutic effects and clinical outcomes.As the results of large-scale clinical trials are released,local treatment such as breast cancer surgery and radiotherapy and systemic treatment strategies such as chemotherapy,endocrinology,and molecular targeting continue to be improved.Accurate understanding of the molecular classification of breast cancer can help patients develop more rational local and systemic treatment strategies to guide their individualized precise treatment.ObjectiveThis study was to investigate the clinicopathological features of NPBC,including histopathological types,histological grades,lymph node status,immunohistochemical markers(ER,PR,HER-2,Ki-67)and their molecular typing characteristics.MethodsAccording to the inclusion criteria and exclusion criteria,totally 69 patients with clinical NPBC were selected as the group N.And over the same period,372 patients with palpable breast cancers(PBC)patients were selected as the group P.Clinical and pathological data of all above breast cancer patients were retrospectively analyzed and compared,which treated by breast surgery in The Third Affiliated Hospital of Zhengzhou University from 2012-01-01 to 2017-07-31.Results1.Comparing the clinicopathological data of patients in group N and group P,there were statistically significant differences in pathological type,lymph node metastasis,Ki-67 expression and molecular typing,all P values were<0.05.2.The rate of ductal carcinoma in situ in group N was higher than group P(31.9% vs 14.8%),x~2=13.129,P=0.001.3.Compared with the group N,the group P was more likely to have lymph node metastasis(25.3%vs 11.6%)and high expression of Ki-67(72.3%vs 55.1%),the x~2 values were 6.122 and 8.178,and the P values were 0.019 and 0.005,respectively.4.When the two groups of patients were Luminal type,the Luminal A type ratio was higher in group N than in group P(45.8%vs 29.9%),x~2=5.585,P=0.022.5.There was no statistically significant difference in histological grade,ER,PR and HER-2,all above P values>0.05.ConclusionsCompared with the PBC,the NPBC was more likely to have pathological type of ductal carcinoma in situ and molecular typing of Luminal A.Compared with the NPBC,the PBC was more likely to have lymph node metastasis,high expression of Ki-67 and had higher metastatic potential,higher proliferative activity.The biological characteristics of NPBC and PBC are very different,and further studies are needed to expand the samples. |
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