Factors associated with the prognosis of breast cancer

  Breast cancer is a major threat to women’s health. In recent years, research has developed rapidly, especially in the early diagnosis and treatment of the disease, and the survival rate of breast cancer has increased significantly. The understanding of the disease and the concept of comprehensive treatment are also evolving, but the prognosis is mostly unknown to patients. Factors related to the prognosis of breast cancer directly guide the choice of treatment plan for breast cancer patients, but in the clinical process, there is a common problem of over-treatment or under-treatment. For the analysis of breast cancer prognostic factors, traditional prognostic indicators such as size of primary foci, number of axillary lymph node metastases, ER/PR status, Her-2 status and other indicators. There are many solid factors affecting the prognosis of breast cancer, and their interrelationships are intricate.  1. The extent of cancer invasion, including the clinical manifestation of the primary cancer and whether the cancer metastasizes along the lymph nodes or blood channels.  2.The presence or absence of lymph node metastasis in the axilla and the metastatic status of regional lymph nodes have traditionally been an important indicator for people to measure the good or bad prognosis.  3.Size is also a very important factor. Generally speaking, the larger the tumor, the worse the prognosis. It has been reported that patients with tumors less than 2 cm, although many of them have positive lymph nodes, have a 5-year survival rate of 100%, while patients with tumors larger than 2 cm have a 5-year survival rate of 62%.  The location of the tumor is related to the prognosis of the disease. Tumors located in the upper inner quadrant are more likely to enter the internal breast lymph nodes, and thus have a poorer prognosis. However, some people disagree with this.  5.The prognosis of breast cancer has long been recognized based on the pathological histology of the cancer. Lowly differentiated cancer cells have high malignancy, early metastasis and poor prognosis; highly differentiated cancer cells have low malignancy, late metastasis and better prognosis.  6.Tumor growth rate has a certain relationship with the prognosis of breast cancer. It has been found that the 5-year survival rate can reach 96% for those with long multiplication time but only 50% for those with short multiplication time in the same stage I cases.  7.Her-2 immunohistochemistry (IHC), grading 0/1+, 2+ or 3+, all 2+ tumors need to be confirmed by FISH, only IHC Her-2 3+ or IHC Her-2 2+/FISH+ are confirmed as Her-2 positive. Her-2 results were systematically correlated with patient tumor size, grade, number of lymph node metastases and ER receptor expression status, and the results showed that the larger the tumor, the higher the grade and the higher the number of lymph node metastases, the higher the percentage of Her-2 positive breast cancer patients. The number of lymph node metastases was 28% for N4, 21% for N1-3 and 20% for N0. Her-2(+) is closely related to a variety of poor clinical prognostic factors and is an important indicator of poor prognosis, as shown in 13% (317/2464) of cases.  8.In recent years, it has been found that there is a certain resistance relationship between the invasion of cancer tumor and the resistance of the body. This means that the prognosis of this disease is not only related to the aggressiveness of the cancer tumor, but also to the immune response caused by the cancer tumor in the body.