Intertumoral heterogeneity of molecular phenotype and analysis of prognosis in multifocal and multicentric breast cancer
10.3760/cma.j.issn0.253-3766.2016.11.006
- VernacularTitle:多灶性多中心性乳腺癌各癌灶的瘤间异质性及预后分析
- Author:
Yishan DUAN
1
;
Qixin MAO
;
Lianfang LI
;
Yadong SUN
;
Lu WANG
;
Shude CUI
Author Information
1. 450008,郑州大学附属肿瘤医院乳腺科
- Keywords:
Breast neoplasms;
Intertumoral heterogeneity;
Molecular phenotype;
Prognosis
- From:
Chinese Journal of Oncology
2016;38(11):833-838
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study was designed to investigate the prognostic implications of the intertumoral heterogeneity of molecular phenotype in multifocal and multicentric breast cancer ( MMBC ) . Methods The clinical and follow-up data of 146 patients with MMBC from Jan.2009 to Dec.2009 treated in Tumor Hospital Affiliated to Zhengzhou University were retrospectively analyzed .We used Kaplan-Meier curves to compare the survivals of patients who had tumors with molecular phenotypic heterogeneity and patients who had multifocal homogeneous tumors in molecular phenotype , and the survivals of patients who had heterogeneous tumor type and grade and who had homogeneous tumor type and grade .The corresponding hazard ratio was calculated by Cox proportional-hazards regression .Results Intertumoral heterogeneity in histological type and grade of multiple breast cancer was detected in 16 of 146 patients (11.0%) and in 10 of 146 patients( 6.8%), respectively.Interfocal heterogeneous molecular phenotype of multiple breast cancer was detected in 24 of 146 patients ( 16.4%) .There was no significant difference in 5-year disease-free survival in multifocal cancer patients who had heterogeneous histological type and grade and who had homogeneous type and grade tumors (75.0%vs.77.3%, P=0.808).Multifocal cancers patients who had heterogeneous tumorsin molecular phenotype compared with those with homogeneous tumors in molecular phenotype had worse 5-year disease-specific survival (78 .7%vs.58.3%,P =0.037) , and had a greater risk of recurrence( HR=2.130, 95%CI=1.027-4.420; P=0.042).Phenotyping the additional cancer foci influenced the therapeutic decision in up to 16 patients (11 .0%) .Conclusoi ns Multifocal breast cancer patients who had heterogeneous tumors in molecular phenotype have a statistically significantly shorter disease-free survival.Phenotyping the additional cancer foci and managing with proper therapeutic decision may reduce the risk of recurrence or metastasis , and improve the outcomes of the patients .
