Clinical Characteristics and Prognosis of ER、PR、HER-2 Negative Breast Cancer

Objective: To investigate the clinical and pathological features of triple negative breast cancer (ER-, PR-, HER-2-), molecular biological characteristics, survival, and prognostic factors. Methods: A retrospective analysis of the Fujian Provincial Hospital Surgical Oncology breast cancer patients were treated from January 1993 to December 2003 a total of 515 cases. ER, PR, HER-2 expression, 515 cases of breast cancer were divided into three groups: the triple negative group (ER-, PR-, HER-2-), HR group (ER / PR) and HER-2 group (ER-, PR-, HER-2). The combination of clinical and pathological characteristics and P53, Ki67, TopII GST-π, P170 immunohistochemical expression analysis of clinical and pathological features of three groups, relapse and survival. Results: 1. Clinical and pathological features: 515 patients with breast cancer, triple negative group accounted for 17% (88/515), with an average age of 48.53 ± 9.09 years, younger age at onset; triple negative group, the average tumor size was 3.52 ± 1.36cm, primary lesions larger; triple negative group infiltrating ductal carcinoma more common, and P53, P170, Ki67, GST-π expression level than those in the other two groups of high (P lt; 0.05). 2. Lymph node metastasis and tumor size relationship: the rate of lymph node metastasis and tumor size of the triple negative group no statistically significant correlation; the HR group lymph node metastasis rate and increased with increasing tumor; transfer of HER-2 group of lymph nodes rate with tumor size nor statistically significant. Time to recurrence and survival: time to recurrence, relapse rate and risk of recurrence: follow-up until January 1, 2008, the follow-up time of 2.61 years - 14.67 years, with a median of 8.35 years, the time to recurrence of triple negative patients with other differences between the two groups was statistically significant (P lt; 0.05); earlier time to recurrence of triple negative group, triple negative group, the recurrence rate was 23.9%, higher relapse rate; risk of recurrence in patients with triple-negative group increased first and then descending trend, after 1-3 years peaked and then began to decrease; risk of recurrence of the HR group, HER2 group was more stable. Compared to the other two groups, the triple negative patients in the five years after surgery higher risk of recurrence (HR: 2.57; CI :1.50-4 .43; P lt; 0.01). Mortality and risk of death: the triple negative group mortality was 22.7%, the mortality rate is higher than the other two groups (HR group, HER-2 group were 10.3%, 8.2%, P lt; 0.05); another two-phase than triple negative patients after five years have a higher risk of death (HR: 2.64; CI :1.52-4 .59; P lt; 0.01), gradually reduced the risk of death after five years. Conclusion: Compared with non-triple negative breast cancer, triple negative breast cancer patients with the following characteristics: age is light, and the original lesion, regardless of tumor size, lymph node metastasis were high early recurrence rate, time to recurrence, mortality high, high risk of recurrence and death in five years after gradually decreased after 5 years.