Nowikiewicz Tomasz, Chmielowska Ewa, Andrusewicz Hanna, Łysik-Miśkurka Joanna, Głowacka Iwona, Sowa Magdalena, Zegarski Wojciech
Pol J Pathol. 2017;68(1):16-25. doi: 10.5114/pjp.2017.67611.
According to the St. Gallen 2011 consensus, proper qualification of breast cancer patients for treatment requires taking into consideration the division into biological types of neoplasms. The goal of this work was to assess the prevalence of all biological types of breast cancer in the population of Kuyavian-Pomeranian province. We determined the influence of particular types of neoplasms on the degree of disease progression and the choice of therapeutic management. The study was conducted on a group of 2653 patients treated surgically due to malignant breast tumors in the Oncology Centre in Bydgoszcz. In the analyzed clinical material we determined the biological type of cancer as well as other prognostic factors. The most commonly identified types of cancer were luminal B1 type (38.4%) and luminal A type (27.4% of cases), followed by a triple-negative type, luminal B2 type and HER2-positive type (respectively: 11.4%, 10.2%, and 6.9% of patients). Estrogen receptors were present in 81.1% and progesterone receptors in 71.4% of subjects. HER2 overexpression was identified in 17.3% of patients. Routine use of a biology-based division into cancer types influences the choice of anti-cancer treatment. Diagnosis of luminal A type of tumor more commonly than other biological types of cancer coexists with lower clinical and pathological disease staging. It allows for more frequent use of sparing surgical techniques in patients. It also makes systemic neoadjuvant chemotherapy unnecessary in the majority of patients (differences in such cases exhibit statistical significance of p < 0.0001).
根据2011年圣加仑共识，对乳腺癌患者进行恰当的治疗评估需要考虑肿瘤的生物学类型划分。本研究的目的是评估库亚维-波美拉尼亚省人群中所有乳腺癌生物学类型的患病率。我们确定了特定肿瘤类型对疾病进展程度和治疗管理选择的影响。该研究针对在比得哥什肿瘤中心因乳腺恶性肿瘤接受手术治疗的2653例患者进行。在分析的临床资料中，我们确定了癌症的生物学类型以及其他预后因素。最常见的癌症类型是腔面B1型（38.4%）和腔面A型（占病例的27.4%），其次是三阴性型、腔面B2型和HER2阳性型（分别占患者的11.4%、10.2%和6.9%）。81.1%的受试者存在雌激素受体，71.4%的受试者存在孕激素受体。17.3%的患者检测到HER2过表达。基于生物学的癌症类型划分的常规应用会影响抗癌治疗的选择。与其他生物学类型的癌症相比，腔面A型肿瘤的诊断更常与较低的临床和病理疾病分期并存。这使得在患者中更频繁地使用保留性手术技术成为可能。这也使得大多数患者无需进行全身新辅助化疗（在这种情况下的差异具有统计学意义，p < 0.0001）。
