International Quarterly Journal of Biology & Life Sciences

eISSN 2320-4257
Biolife, Volume 3, Issue 3, 2015

Research Article

Biological subtypes of breast cancer and their impact on recurrence and survival
rates: Alexandria surgical oncology  unit experience

Mostafa Elsayed*1, Tarek Elfayoumi2, and ATAwad3

1 General Surgery Department, Alexandria Student University Hospital
2-3 General Surgery Department, Faculty of Medicine, University of Alexandria



The effect of breast cancer molecular subtypes and treatment on survival, loco regional and distant recurrences were analyzed. Aiming to decrease
the incidence of recurrence, continuous urgue exists about the optimal surgical decision (BCS or mastectomy) to breast cancer subtypes (Triple
negative breast cancer and her2 enriched. Alexandria Surgical Oncology Unit Data base was used to identify eligible breast cancer patient. Female
patients who were diagnosed and/or treated from January 2000 to December 2010 with primary, invasive, unilateral breast cancer at our hospital
were included. A total of 664 patients made up the study population. Kaplan Meier curves and log rank tests were used to estimate 5 year Loco
regional and distant recurrence and to compare them across strata. Cox proportional hazards models were used to calculate hazard ratios and 95%
confidence intervals to fit the effect of conservative surgery, mastectomy and other independent variables. After a median follow up of 5 year
(range 1 10), 16 (6.72%) patients in the BCS groups had Loco regional recurrence (LRR) versus 10(2.34%) patients in the mastectomy group. For
distant recurrence, 37(8.68%) patients had distant recurrence in the mastectomy group versus 10(4.2%) patients in the BCS group.
Lymphovascular invasion (HR 2.55; 95% CI, 076 to 8.49) and an extensive intraductal component (HR, 2.22; 95% CI, 0.69 to 7.15) are risk factors
for (LRR) after BCT, however nodal status represents a risk factor for (LRR) after both BCS & MRM. Tumor size, nodal status, high histologic grade &
breast cancer diagnosed at a young age (≤ 35 years) are correlated with higher distant recurrence rates after BCT, whereas lymphovascular
invasion & triple negative breast cancer and Her 2 enriched breast cancer are predictive of the risk of distant recurrence after MRM. One of the
main predictors of breast cancer survival is molecular subtypes. Luminal A subtype is associated with low risk of recurrence. Women with Her2
enriched, triple negative breast cancer, luminal B subtypes have the poorest survival. For TNBC patients breast conservative therapy is more
beneficial than mastectomy. Putting in mind that TNBC subtype predicts a poorer prognosis than non TNBC breast cancer which make the need for
newer innovation adjuvant therapy.

Keywords: Biological subtypes, breast conservative surgery, modified radical mastectomy.

Published online 24 August, 2015
© 2015 Published by Global Science Publishing Group, USA

How to Cite this Article:

Mostafa Elsayed, Ahmed Tarek, Tarek Elfayoumi (2015).   Biological subtypes of breast cancer and their impact on recurrence and survival rates:
Alexandria surgical oncology unit experience. Biolife, 3(3), pp 722-729. doi:10.17812/blj.2015.3324

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