Study On The Clinical And Pathological Features Of Calcified Invasive Breast Cancer

Background:Breast cancer,as a malignant tumor in women,has become an important killer to women’s health.Breast calcification is a common sign of breast mammography,which can exist in benign and malignant breast diseases.It can appear alone and with other signs,sometimes as the first symptom.It is helpful for clinicians to grasp the characteristics of calcified breast cancer patients quickly in their work,and to provide reference for the individualized treatment with the research of the clinical and pathological characteristics.Methods:According to the inclusion criteria,a total of 279 patients with invasive breast cancer were collected from January 1st to December 31st in 2018 admitted to the First Affiliated Hospital of Zhengzhou University,all of them were confirmed to have invasive breast cancer by pathological diagnosis.The χ~2 test was used to study the correlation between calcification and clinicopathologic data(age,tumor diameter,lymph node status,number of lymph node metastases,pathological grades,ER,PR,HER-2,Ki-67,molecular subtypes).The Pearson χ~2 test was used to analyze the correlation between the morphology and distribution of calcification in invasive breast cancer and the molecular classification and the biological characteristics of breast cancer.The logistic regression model was used to analyze the influencing factors of calcification in invasive breast cancer.Results:1.Of the 279 patients pathologically confirmed invasive breast cancer,181 were accompanied by calcification and 98 had no calcification.Confirmed by statistical analysis,the invasive breast cancer calcification has no correlation with patient’s age(χ~2=2.488,P=0.288),lymph node status(χ~2=0.974,P=0.324),number of lymph node metastases(χ~2=2.711,P=0.100)and pathological grades(χ~2=5.299,P=0.073),but it has correlation with tumor diameter(χ~2=19.638,P<0.001).Compared with non-calcified invasive breast cancer,patients with calcified invasive breast cancer with tumor diameter>2cm are the majority(71.8%).The expression of ER(χ~2=1.772,P=0.183),PR(χ~2=0.629,P=0.428)has no correlation with calcification.But the expression of HER-2(χ~2=9.973,P=0.002)and Ki-67(χ~2=9.014,P=0.003)and molecular classification(χ~2=12.587,P=0.006)are associated with calcification.2.There is no significant correlation between the calcified form(χ~2=10.245,P=0.331)and distribution(χ~2=7.457,P=0.826)in invasive breast cancer and breast cancer molecular classification.Calcified form is significantly associated with tumor diameter(χ~2=9.381,P=0.025),and it has no significant correlation with lymph node metastasis(χ~2=2.343,P=0.504)and pathological grades(χ~2=5.024,P=0.541).Calcified distribution has no significant correlation with tumor diameter(χ~2=5.156,P=0.272),lymph node status(χ~2=3.469,P=0.483),pathological grades(χ~2=7.712,P=0.462).3.Tumor diameter,the expression of ER and Ki-67 and molecular typing are independent influencing factors of calcification in invasive breast cancer.The risk of calcification in the group of tumor diameter>2cm is 2.814 times than that in the group of tumor diameter ≤2cm(OR:2.814,95%CI:1.584～4.999).The calcification risk in Group Ki-67≥15%is 5.313 times than that in Group Ki-67<15%(OR:5.313,95%CI:1.194～23.649).The positive expression of ER does not increase the risk of calcification.Luminal A type breast cancer has a higher possibility of calcification than Her-2 overexpression and triple-negative breast cancer.Conclusion:1.Whether invasive breast cancer has calcification is not related to the patient’s age,lymph node status,number of lymph node metastases,pathological grades,the expression level of ER and PR,but related to the tumor diameter,expression of HER-2 and Ki-67,and molecular classification.2.There is no significant correlation between the morphology and distribution of calcification and the molecular classification of breast cancer.In the study of calcification morphology and tumor biological characteristics of calcified invasive breast cancer,it is found that calcification morphology is significantly correlated with tumor diameter,while it has no correlation with lymph node status and pathological grades.There is no significant correlation between calcification distribution and tumor diameter,lymph node status or pathological grades.3.Tumor diameter,ER status,Ki-67 status and molecular subtypes are independent factors influencing calcification in invasive breast cancer.