Analysis Of The Effect And Prognostic Factors Of Neoadjuvant Chemotherapy For Breast Cancer

Objective:This article retrospectively analyzed the relevant clinical medical records of breast cancer neoadjuvant chemotherapy patients treated in our hospital and analyzed the immunohistochemical indexes(ER,PR,Ki-67,HER-2)before and after neoadjuvant chemotherapy(NAC)Changes,and explore the factors that may be related to the prognosis of breast cancer NAC,hoping that this study can promote the further development of breast cancer NAC therapy and benefit patients.Methods:A total of 124 patients with breast cancer NAC who were treated in our hospital from January 2014 to January 2017 were selected(NAC followed the doctor's advice after pathological diagnosis).Collect relevant patient case data for retrospective statistical analysis.The tumor size and the changes of immunohistochemical indexes before and after NAC were recorded during each course of NAC.According to the direction of exploration,NAC patients were grouped for prognostic comparative analysis,SPSS 21.0 software was used for statistical analysis,? 2 test was used for univariate analysis;Kaplan-Meier method was used for survival analysis,and survival rate comparison was by Log-rank test.P <0.05 was considered statistically significant.Results:1.In the study of the changes of clinical stages of the tumor before and after NAC,it was found that the effect of NAC on the phase III and phase II tumors was significant.In addition,it was found that NAC had a good effect on the metastasis of supraclavicular lymph nodes.The clinical negative rate was 61.1% after NAC,and the difference between before and after NAC was statistically significant(P < 0.05),it has a certain significance to reduce the stage of breast cancer and the scope of operation.2.When studying the change of tumor retraction during the course of NAC patients,it was found that after the total tumor retraction was minimized,the tumor continued to increase in the course of treatment,but there was a tendency to increase,but the individual difference was large.The total tumor size studied in this article was in the fourth course of treatment After reaching the minimum.3.Immunohistochemical indexes(ER,PR,Ki-67,HER-2)can change before and after breast cancer NAC,but only Ki-67 changes are statistically significant in this study(P<0.05),NAC can Reduce the expression level of Ki-67.4.In exploring the effect of Ki-67 changes on 5-year DFS of NAC patients,it was found that: Ki-67 decreased group>Ki-67 unchanged group>Ki-67 increased group,and the difference in DFS among the threegroups was statistically significant(P<0.05).5.When exploring the impact of different NAC programs on prognosis,it was found that there was no statistically significant difference in prognosis between different NAC programs(P>0.05).6.In exploring the effect of different molecular classifications on the prognosis after NAC,it was found that the 5-year DFS of Luminal NAC patients was higher than that of HER-2 overexpression and Basal-like NAC patients.The difference in DFS was statistically significant(P<0.05).7.In a comparative analysis of pCR patients and non-pCR patients after NAC,it was found that the 5-year DFS of pCR patients was greater than the 5-year DFS of non-pCR patients,and the difference was statistically significant(P<0.05).Conclusion:1.During the NAC course,the tumor shrinkage is not always shrinking(the overall tumor size in this article is the smallest after the fourth treatment period).After some tumors shrink to the smallest size,the tumor continues to increase but continues to increase.But individual differences are obvious.2.NAC has a good effect on metastatic supraclavicular lymph nodes,and has a certain significance for the reduction of breast cancer and the reduction of surgical scope.3.The change of Ki-67 after NAC is statistically significant.NAC can reduce the expression level of Ki-67.The change state of Ki-67 after NAC can predict the prognosis of NAC patients.The prognosis of patients with reduced Ki-67 group is better.The risk of breast cancer recurrence and metastasis is low.4.The prognosis of patients with Luminal type after NAC is better than that with HER-2 overexpression and Basal-like type.5.The prognosis of pCR patients after NAC is better than that of non-pCR patients.