Analysis Of Risk Factors And Prognostic Factors For Distant Metastasis Of Breast Cancer After Operation

Objective: To explore the correlation between risk factors and prognostic factors of postoperative distant metastasis in breast cancer patients,the relationship between different molecular types of breast cancer and distant metastasis site and time,so as to provide a basis for early clinical prediction and treatment of distant metastasis of breast cancer.Methods: Retrospective analysis was performed on the clinical data of 65 patients with distant metastasis who were pathologically diagnosed with breast cancer after surgical treatment in the first affiliated hospital of Nan Chang university from January 2010 to December 2015 and 107 patients who have not suffered recurrence and metastasis so far.Results: 1.Clinical data of 172 patients were collected,including 65 in the metastatic group and 107 in the non-metastatic group.There were statistically significant differences in tumor size,number of positive lymph nodes and tumor markers between the two groups(P < 0.05),but no statistically significant differences in age,BMI,menopausal status,vascular status,histopathological type,histological grade,and molecular typing.2.The number of positive lymph nodes(AUC = 0.762,P<0.001),CEA(AUC = 0.689,P<0.001)and CA153(AUC = 0.760,P<0.001)were independent risk factors for distant metastasis after breast cancer surgery,with critical values of 3.5,4.0750U/ml and 18.9050U/ ml,respectively.3.Luminal B type breast cancer is more prone to bone metastasis,while triple negative breast cancer is more prone to visceral metastasis(P < 0.05).The peak of visceral metastasis occurred in the 2nd year after surgery(32%,8/25),while the peak of bone metastasis occurred in the 3rd year after surgery(27.5%,11/40).The peak metastasis rate of Luminal B type breast cancer was in the 3rd year after surgery(25.6%,10/39),while the rates of her-2 and triple negative breast cancer metastasis remained the same in the first 3 years.4.The mortality risk of patients with positive her-2 was higher than that of patients with negative her-2,HR=2.167(95%CI :1.031-4.554).The mortality risk of patients with multiple site metastasis was higher than that of patients with single site metastasis,HR=3.257(CI:1.196-8.867).The mortality risk of patients with chemotherapy alone was higher than that of patients with combination therapy,HR= 4.215(CI:1.584-11.211).Conclusion: 1.The number of lymph node metastases,CEA and CA153 levels at initial diagnosis can help predict distant metastasis of breast cancer.2.Different molecular typing may have specific primary target organ metastasis,and different sites of metastasis and the time of molecular typing metastasis are different.3.The state of her-2,the number of distant metastases and the mode of treatment are the relevant risk factors for the prognosis.