| PurposeA previous study about invasive breast carcinoma of no special type(IBC-NST)and mixed ductal/lobular breast carcinoma showed that mixed ductal/lobular breast carcinoma has special immunohistochemical phenotype compared with IBC-NST,and its prognosis was different from IBC-NST.Invasive breast carcinoma of histological special types(IBC-ST)was a relatively rare breast cancer.Most of IBC-ST had subtypes and mixed manifestations,and there were differences among them.In clinical,most of the ductal carcinoma in situ(DCIS)were accompanied by other types of breast cancer.In order to understand the pathological and clinical features and prognostic factors of these mixed and pure pathological types of IBC by this study.Materials and MethodsA total of 403 cases were selected from January 2013 to June 2018 in the Dalian Medical University to retrospective.The minimum age of the study subjects was 26 years,the maximum age was 87 years,the median age was 55 years.The follow-up time was 10-70 months,and the median follow-up time was 37 months.They were grouped according to their pathological types.IBC-ST(31 cases),IBC-NST/DCIS(32 cases)and IBC-NST/IBC-ST(16 cases)were used as the study group,and IBC-NST(324 cases)were used as the control group.To understand the proportion of all breast cancer in each group,and study the distribution of age,lymph node metastasis,HR,HER-2,the index of Ki-67 and TOPO?.Respectively reaserched the Intragroup relationship between HER-2 and ER,PR,the index of Ki-67 in every group to study the features about HER-2 with ER,PR and the index of Ki-67 in every group.Univariate survival analysis and multivariate survival analysis were performed for patients in the study group(lymph node metastasis,PR,HER-2,and the index of Ki-67).The univariate(lymph node metastasis,curative effect,HR,HER-2 and the index of Ki-67)and multivariate survival analysis were analyzed in patients with IBC-NST/BC-OT treated with neoadjuvant therapyResult1 IBC-ST,IBC-NST,IBC-NST/DCIS and IBC-NST/IBC-ST respectily accounted for 7.7%,80.4%,7.9%,and 4%.The age was less than or equal to 40 years old accounted for 9.7%.The overall positive rate of lymph nodes was 41.7%.ER positive rate was 73.7%.The positive rate of PR was 67.2%.The positive rate of HER-2 was 16.9%.The high expression rate of the index of Ki-67 was 9.7%.TOPO ? positive expression rate was 85.4%.MUC was most of the Luminal type and the expression of ER and PR was positive,HER-2 was negative and Ki-67 always was low expression.IMPC,HER-2 always was positive.MC,HR always was negative.SqCC and ACC were mostly triple-negative breast cancer.2 There was no significant difference in IBC-ST,IBC-NST,IBC-NST/DCIS and IBC-NST/IBC-ST about the age and expression of ER and PR(P>0.05).The positive rates of HER-2,Topo ? and lymph nodes of IBC-ST were the lowest,and the positive rates of TOPO ? in IBC-NST were the highest.The positive rate of lymph nodes in IBC-NST/DCIS was higher than that in IBC-NST/IBC-ST.The positive rate of HER-2 in IBC-NST/DCIS was higher than that in IBC-NST.The high expression rate of Ki-67 in IBC-NST/DCIS was higher than that in IBC-ST,the high expression rate of Ki-67 in IBC-NST was lower than tha in IBC-ST.All of them had statistic significance(P<0.05).And there were no difference about the other paired comparison.3 There was no significant relationship between the expression of HER-2 and the expression of ER,PR and Ki-67 in IBC-ST.The positive rate of ER was high,the expression of PR was always high,and Ki-67 has low expression,in IBC-NST with HER-2-.In IBC-NST with HER-2+,negative ER(P<0.001),PR(P<0.001)and high expression of Ki-67(P<0.001)was more frequentaly observed.IBC-NST/DCIS has more negative PR(P<0.001)and more negative ER(P=0.007)in HER-2+patients.and more high expression of PR and the positive expression of ER with HER-2-.In IBC-NST/IBC-ST,HER-2-always acompanied by low expression of Ki-67(P<0.05).4 Univariate survival curve analysis showed that pathological types,lymph node,expression of HER-2(positive,negative),Ki-67(low,high)and PR(low,high,negative)had no significant effective on RFS in patients with IBC-NST/BC-OT and IBC-ST5 In the Kaplan-Meier survival analysis of cases treated with neoadjuvant chemotherapy in IBC-NST/BC-OT,the efficacy of neoadjuvant chemotherapy,the expression of HER-2 and HR were associated with RFS(P=0.009,P<0.001,P<0.001)In COX multivariate survival analysis,none of them can be recognised as an independent predicting factor for prognostic(P>0.05)Conclusion1 The young BC of onset,the rate of positive expression of ER and PR in IBC-ST,IBC-NST,IBC-NST/DCIS and IBC-NST/IBC-ST were similar.The positive rates of HER-2,Topo ? and lymph nodes of IBC-ST were the lowest,and the positive rates of TOPO ? in IBC-NST were the highest.Among them,the pathological and immunohistochemical findings of rare types of BC had their own characteristics2 Most of IBC-NST/DCIS are HER-2+HR+and LuminalA,and most of IBC-NST were HER-2+HR-and LuminalA.3 In this study,the lymph node metastasis of IBC-NST/BC-OT and IBC-ST,the expression of HER-2(postive,negetive),Ki-67(low expression,high expression)and PR(low expression,high expression,negative)were not related to RFS4 In patients with IBC-NST/BC-OT treated with neoadjuvant chemotherapy,patients with HER-2 positive,HR positive and stable chemotherapy had a high recurrence-free survival rate.None of the above could be used as an independent prognostic factor for IBC-NST/BC-OT with neoadjuvant chemotherapy. |
PDF Full Text Request