Fine needle aspiration cytology in the management of palpable benign and malignant breast disease. Correlation with clinical and mammographic findings

Two surgeons in a health maintenance organization group practice performed 280 fine needle aspirations (FNAs) on 257 palpable breast lesions in 200 patients. The cytology was interpreted by four pathologists at a community hospital. FNA cytology had a sensitivity of 96% and a specificity of 94% in these cases; there were no false-positive diagnoses of cancer. FNA cytology improved the identification of benign disease and decreased the risk of missing cancers. FNA cytology also improved the predictive value of mammographic information and was more helpful than mammography in demonstrating the need for biopsy of small palpable lesions that turned out to be "minimal" breast cancers.     

Staging practices and breast cancer stage among population-based registries in the MENA region

BackgroundAvailability of stage information by population-based cancer registries (PBCR) remains scarce for diverse reasons. Nevertheless, stage is critical cancer control information particularly for cancers amenable to early detection. In the framework of the Global Initiative for Cancer Registry Development (GICR), we present the status of stage data collection and dissemination among registries in the Middle East and Northern Africa (MENA) region as well as the stage distribution of breast cancer patients.MethodsA web-based survey exploring staging practices and breast cancer stage was developed and sent to 30 PBCR in 18 countries of the MENA region.ResultsAmong 23 respondent PBCR, 21 collected stage data, the majority (80%) for all cancers. Fourteen registries used a single classification (9 TNM and 5 SEER), 7 used both staging systems in parallel. Out of 12,888 breast cancer patients (seven registries) 27.7% had unknown TNM stage (11.1% in Oman, 46% in Annaba). When considering only cases with known stage, 65.3% were early cancers (TNM I+II), ranging from 57.9% in Oman to 83.3% in Batna (Algeria), and 9.9% were stage IV cancers. Among the nine registries providing SEER Summary stage for breast cancer cases, stage was unknown in 19% of the cases, (0 in Bahrain, 39% in Kuwait). Stage data were largely absent from the published registry reports.ConclusionDespite wide stage data collection by cancer registries, missing information and low dissemination clearly limit informing efforts on early detection. The use of two classification systems in parallel implies additional workload and might undermine completeness. The favourable results of early cancer (TNM I+II) in two thirds of breast cancer patients needs to be interpreted with caution and followed up in time. Although efforts to improve quality of stage data are needed, our findings are particularly relevant to the WHO Global Breast Cancer Initiative.     

Variation in management of small invasive breast cancers detected on screening in the former south east Thames region: observational study.

OBJECTIVE: To examine the variation in surgical and adjuvant treatment of breast cancer of known histology and detected on screening in a large cohort of patients treated by the surgeons of a health region. DESIGN: Part prospective, part retrospective observational study using the databases of a region''s breast screening programme and of the cancer registry. SETTING: The former South East Thames region. SUBJECTS: 600 women aged 49-79 who presented during 1991-2 with invasive breast cancer up to 20 mm in diameter that had been detected on screening. These patients were treated by 35 surgeons. MAIN OUTCOME MEASURES: Mastectomy rate by surgeon and the use of adjuvant treatment (radiotherapy, tamoxifen, and chemotherapy) were compared with risk factors, tumour grade, resection margins, and axillary node status. RESULTS: The mastectomy rate varied between nil and 80%, although the numbers at these extremes were small (0/13 v 8/10). Surgeons operating on more than 20 such cases had a lower mastectomy rate (15%) than surgeons treating fewer cases (23%), but this difference was confounded by variation in casemix. There were also wide variations in mastectomy rates and in axillary sampling rates that were independent of casemix or caseload. There was broad agreement on the use of adjuvant tamoxifen (94%), but few patients received chemotherapy (2.5%). 78 patients (19%) did not receive radiotherapy, including 51 out of 317 patients with unfavourable tumours, and 26 patients did not receive tamoxifen. Whether the patient received adjuvant treatment was more dependent on referral by the surgeon than the risk factors for local recurrence and was independent of caseload. CONCLUSION: Mastectomy rates for similar tumours vary widely by surgeon independently of casemix or caseload, but surgeons with a higher caseload tend to have a lower mastectomy rate. Omission of postoperative radiotherapy or tamoxifen after conservative treatment is not related to risk factors for local recurrence or caseload. Confidential feedback of treatment profiles to individual surgeons has been used, but when benefit has been established treatment should be guided by evidence based protocol.     

Role of non-medical staff in screening for breast cancer.

In a feasibility study of mass population screening for breast cancer by clinical examination and mammography the ability of non-medical staff (nurses and radiographers) to act as primary screeners was compared with that of medical staff (surgeons and radiologists). In 240 women with cancer the rate of detection of the disease by the non-medical staff was comparable to that of the medical staff, although the non-medical staff detected more cancers by mammography alone than did the medical staff. The rate of detection by surgeons and particularly nurses was lower in women without symptoms than in those with symptoms, whereas the incidence of detection by radiologists and radiographers was lower in women aged under 50 than in those over 50. The rate of detection by all groups of staff significantly increased with increases in tumour size. The results suggest that non-medical staff can act effectively as primary screeners, but that for the detection of cancer in asymptomatic women, particularly those over 50, mammography is probably more effective than clinical examination.     

Reconsidering low-dose aspirin therapy for cardiovascular disease: a study protocol for physician and patient behavioral change

Background

Opinion leaders represent one way to disseminate new knowledge and influence the practice behaviors of physicians. This study explored the stability of opinion leaders over time, whether opinion leaders were polymorphic (i.e., influencing multiple practice areas) or monomorphic (i.e., influencing one practice area), and reach of opinion leaders in their local network.

Methods

We surveyed surgeons and pathologists in Ontario to identify opinion leaders for colorectal cancer in 2003 and 2005 and to identify opinion leaders for breast cancer in 2005. We explored whether opinion leaders for colorectal cancer identified in 2003 were re-identified in 2005. We examined whether opinion leaders were considered polymorphic (nominated in 2005 as opinion leaders for both colorectal and breast cancer) or monomorphic (nominated in 2005 for only one condition). Social-network mapping was used to identify the number of local colleagues identifying opinion leaders.

Results

Response rates for surgeons were 41% (2003) and 40% (2005); response rates for pathologists were 42% (2003) and 37% (2005). Four (25%) of the surgical opinion leaders identified in 2003 for colorectal cancer were re-identified in 2005. No pathology opinion leaders for colorectal cancer were identified in both 2003 and 2005. Only 29% of surgical opinion leaders and 17% of pathology opinion leaders identified in the 2005 survey were considered influential for both colorectal cancer and breast cancer. Social-network mapping revealed that only a limited number of general surgeons (12%) or pathologists (7%) were connected to the social networks of identified opinion leaders.

Conclusions

Opinion leaders identified in this study were not stable over a two-year time period and generally appear to be monomorphic, with clearly demarcated areas of expertise and limited spheres of influence. These findings may limit the practicability of routinely using opinion leaders to influence practice.     

Survey of treatment of primary breast cancer in Great Britain.

A postal survey of current management of breast cancer among surgeons in Great Britain was carried out. The results showed that there is no consensus among surgeons about the treatment of primary breast cancer. Many different types of primary surgery are practised, and patterns of referral for postoperative radiotherapy vary widely. Adjuvant systemic treatment is given often by some surgeons and not at all by others. Few patients are entered into controlled randomised trials.     

DNA grading of malignancy in breast cancer. Prognostic validity, reproducibility and comparison with other classifications

The prognostic significance of the "DNA malignancy grade" (DNA-MG) was tested in a series of 104 breast cancer patients in comparison with TNM staging, histomorphologic grading according to Bloom and Richardson, mean nuclear area (MNA) and DNA-histogram classification according to Auer. The reproducibility and representativity of the grading systems were investigated, and their results in primary tumors and lymph node metastases were compared. The scalar DNA-MG was assessed on monolayer smears prepared from paraffin-embedded tissues; the smears were automatically Feulgen stained and used for rapid interactive DNA cytometric evaluation by an automated microscope and a TV image-analysis system. TNM staging showed the highest correlation with survival, followed by histomorphologic grading and DNA-MG; MNA and the DNA-histogram classification failed to give statistically significant prognostic information. Both histomorphologic grading and DNA-MG were identified as parameters adding independent prognostic information to the TNM staging. However, only DNA-MG demonstrated an acceptable reliability, with small 95% ranges between repeated measurements within the primary tumor (+/- 0.3 DNA-MG) and a strong correlation between the results in the primary tumor and its lymph node metastases. These findings show that the DNA-MG is a valid and reliable prognostic index that adds significant prognostic information to TNM staging.     

Prise en charge multidisciplinaire du cancer du sein de stade précoce. Apport de la biologie

Early-breast cancer treatment is based on a multimodality approach with the common use of clinical and histological prognostic factors to determine locoregional and systemic treatments. The entire scientific community is strongly involved in the management of this disease: radiologists for screening and early diagnosis, gynaecologists, surgery oncologists and radiation oncologists for locoregional treatments, pathologists and biologists for personalized characterization and medical oncologists for systemic therapies. Recently, new biological tools have established different prognostic subsets of breast cancers and developed predictive markers to miscellaneous treatments. The aim of this article is to detail the contribution of biological tools in the locoregional management of early breast cancer.     

Resection line disease in stomach cancer. British Stomach Cancer Group.

In a prospective multicentre study of gastric adenocarcinoma the problem of microscopic disease at the resection line was investigated. Of 390 patients with resected gastric cancer, 85 (22%) had disease of the resection margins--32 at the oesophagus, 20 at the gastric margin, 17 at the duodenum, and six at both margins (10 were unspecified). Some 105 resections were considered palliative and 285 curative; 39 and 46 respectively had resection line disease. When resection margin clearance had been achieved a significantly improved survival was found, both overall (p = 0.0001), in the curative group (p = 0.0009), and in those with serosal disease but no microscopic disease of the lymph nodes (p = 0.0109). When the resection margin was diseased the survival rate for TNM stage IIS fell to that of stage IVA; 16% of those having curative surgery had had inadequate resections. The results of this study show that microscopic disease at the resection line influences long term survival and that surgeons should ensure that resection lines are clear. It also shows that the classification of patients who have resection line disease should be downgraded to stage IVA in the TNM staging system and they should be considered to have had only a palliative resection.     

Can the Tumor Deposits Be Counted as Metastatic Lymph Nodes in the UICC TNM Staging System for Colorectal Cancer?

Objective

The 7th edition of AJCC staging manual implicitly states that only T1 and T2 lesions that lack regional lymph node metastasis but have tumor deposit(s) will be classified in addition as N1c, though it is not consistent in that pN1c is also an option for pT3/T4a tumors in the staging table. Nevertheless, in this TNM classification, how to classify tumor deposits (TDs) in colorectal cancer patients with lymph node metastasis (LNM) and TDs simultaneously is still not clear. The aim of this study is to investigate the possibility of counting TDs as metastatic lymph nodes in TNM classification and to indentify its prognostic value for colorectal cancer patients.

Methods and Results

In this retrospective study, 513 cases of colorectal cancer with LNM were reviewed. We proposed a novel pN (npN) category in which TDs were counted as metastatic lymph nodes in the TNM classification. Cancer-specific survival according to the npN or pN category was analyzed using Kaplan-Meier survival curves. Univariate and multivariate analyses were performed to indentify significant prognostic factors. Harrell''s C statistic was used to test the predictive capacity of the prognostic models. The results revealed that the TD was a significant prognostic factor in colorectal cancer. Univariate and multivariate analyses uniformly indicated that the npN category was significantly correlated with prognosis. The results of Harrell''s C statistical analysis demonstrated that the npN category exhibited a superior predictive capacity compared to the pN category of the 7th edition TNM classification. Moreover, we also found no significant prognostic differences in patients with or without TD in the same npN categories.

Conclusions

The counting of TDs as metastatic lymph nodes in the TNM classification system is potentially superior to the classification in the 7th edition of the TNM staging system to assess prognosis and survival for colorectal cancer patients.     

Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial.

OBJECTIVES--To assess outside a clinical trial the psychological outcome of different treatment policies in women with early breast cancer who underwent either mastectomy or breast conservation surgery depending on the surgeon''s opinion or the patient''s choice. To determine whether the extent of psychiatric morbidity reported in women who underwent breast conservation surgery was associated with their participation in a randomised clinical trial. DESIGN--Prospective, multicentre study capitalising on individual and motivational differences among patients and the different management policies among surgeons for treating patients with early breast cancer. SETTING--12 District general hospitals, three London teaching hospitals, and four private hospitals. PATIENTS--269 Women under 75 with a probable diagnosis of stage I or II breast cancer who were referred to 22 different surgeons. INTERVENTIONS--Surgery and radiotherapy or adjuvant chemotherapy, or both, depending on the individual surgeon''s stated preferences for managing early breast cancer. MAIN OUTCOME MEASURES--Anxiety and depression as assessed by standard methods two weeks, three months, and 12 months after surgery. RESULTS--Of the 269 women, 31 were treated by surgeons who favoured mastectomy, 120 by surgeons who favoured breast conservation, and 118 by surgeons who offered a choice of treatment. Sixty two of the women treated by surgeons who offered a choice were eligible to choose their surgery, and 43 of these chose breast conserving surgery. The incidences of anxiety, depression, and sexual dysfunction were high in all treatment groups. There were no significant differences in the incidences of anxiety and depression between women who underwent mastectomy and those who underwent lumpectomy. A significant effect of surgeon type on the incidence of depression was observed, with patients treated by surgeons who offered a choice showing less depression than those treated by other surgeons (p = 0.06). There was no significant difference in psychiatric morbidity between women treated by surgeons who offered a choice who were eligible to choose their treatment and those in the same group who were not able to choose. Most of the women (159/244) gave fear of cancer as their primary fear rather than fear of losing a breast. The overall incidences of psychiatric morbidity in women who underwent mastectomy and those who underwent lumpectomy were similar to those found in the Cancer Research Campaign breast conservation study. At 12 months 28% of women who underwent mastectomy in the present study were anxious compared with 26% in the earlier study, and 27% of women in the present study who underwent lumpectomy were anxious compared with 31% in the earlier study. In both the present and earlier study 21% of women who underwent mastectomy were depressed, and 19% of women who underwent lumpectomy in the present study were depressed compared with 27% in the earlier study.) CONCLUSIONS--There is still no evidence that women with early breast cancer who undergo breast conservation surgery have less psychiatric morbidity after treatment than those who undergo mastectomy. Women who surrender autonomy for decision making by agreeing to participate in randomised clinical trials do not experience any different psychological, sexual, or social problems from those women who are treated for breast cancer outside a clinical trial.     

Classification et aspects anatomopathologiques des tumeurs endocrines digestives

Gastrointestinal and pancreatic endocrine tumors GIPET are rare and represent only 2 % of malignant tumors. Beyond their common features, endocrine tumors are characterized by a marked diversity, which results from the large functional, structural and embryological heterogeneity of normal endocrine cells. Despite the rational basis for predicting prognosis provided by the WHO classification, there is no reliable means of predicting the clinical course of patients with gastrointestinal and pancreatic endocrine tumors. The current criteria used for the definition of the tumor grade remain unsatisfactory. According to the WHO classification system, pathologists vary significantly in their reporting of endocrine tumors. Recently, the European Neuroendocrine Tumour Society (ENETS) has proposed a TNM (tumor–node–metastasis) classification for gastrointestinal and pancreatic endocrine tumors. The use of this classification is considered simple and valuable. It is hoped that the combination of WHO classification, with anatomical staging systems TNM, and possibly incorporating molecular features of gastrointestinal and pancreatic endocrine tumors will provide clinicians with effective means of classification and prognostication of patients with these tumors.     

Appraisal of the World Health Organization classification of lung tumours.

The 1967 World Health Organization (WHO) classification of the histologic types of lung tumours has been examined in relation to 303 tumours of patients admitted to a national trial of the treatment of lung cancer. In 63 instances (20%) there was disagreement between the diagnoses of the local pathologist and the reference pathologist. The slides for these 63 tumours were reviewed by two other pathologists, and the slides for 60 tumours for which there was agreement between the local and reference pathologists were reviewed by one of the other pathologists. The main disagreement was in the diagnosis of epidermoid (squamous) tumours. It is apparent that many pathologists do not adhere to the strict criterion of the presence of keratinization or intercellular prickles or both for the diagnosis of epidermoid carcinoma. In addition, there was substantial variation in the use of subtypes within the WHO classification. Use of the revised classification proposed by the WHO would have removed a small amount of the variation from these findings but would not have affected the main discrepancy. Stricter attention to the definition of types is required for a uniform approach to the histologic classification of lung tumours.     

Survival outcome of care by specialist surgeons in breast cancer: a study of 3786 patients in the west of Scotland.

OBJECTIVE--To compare survival outcome for patients with breast cancer cared for by specialist and non-specialist surgeons in a geographically defined area. DESIGN--Retrospective study of all female patients aged under 75 years in the area treated between 1980 and June 1988 (before breast screening began). Patients were identified from the cancer registry and from pathology records of all hospitals in the area. Specialist surgeons were identified by one author. All other surgeons caring for patients from the area were considered non-specialists. SETTING--A geographically defined population in urban west of Scotland. SUBJECTS--3786 patients with histologically verified breast cancer operated on between 1 January 1980 and 30 June 1988 and followed to 31 December 1993. MAIN OUTCOME MEASURES--Five and 10 year survival rates for specialists and non-specialists; relative hazard ratios derived from Cox''s proportional hazards model adjusted for prognostic factors--age, socioeconomic status, tumour size, and nodal involvement. RESULTS--The five year survival rate was 9% higher and the 10 year survival 8% higher for patients cared for by specialist surgeons. A reduction in risk of dying of 16% (95% confidence interval 6% to 25%) was found after adjustment for age, tumour size, socioeconomic status, and nodal involvement. The benefit of specialist care was apparent for all age groups, for small and large tumours, and for tumours that did and did not affect the nodes and was consistent across all socioeconomic categories. CONCLUSIONS--Survival differences of the magnitude demonstrated have implications for the provision of services for the treatment of women with breast cancer. There is a need to improve equity in the treatment of breast cancer.     

Expression of γ-H2AX and patient prognosis in breast cancer cohort

H2AX phosphorylation is a novel marker of DNA double-stranded breaks. In the present study, we assessed the γ-H2AX expression, its association with other clinicopathologic characteristics, and the prognosis in a cohort of 97 patients with breast cancer. Ninety-seven specimens of tumor tissue and 77 adjacent normal tissues from patients with breast cancer were examined. All patients underwent modified radical mastectomy or local tumor resection without lymph node dissection. γ-H2AX expression was assessed by standard immunohistochemistry. Patients were followed after surgery for a mean duration of 70.1 ± 18.7 months (range, 6-93 months). The γ-H2AX staining was positive in 27 (27.8%) patients. The positive rates of H2AX were 26.0% and 2.6% in tumor tissue and adjacent normal tissues, respectively. γ-H2AX positive status was negatively associated with TNM staging, with 24 positive cases (32.4%) in TNM staging I-II, while no positive cases in TNM staging III-IV (P = 0.026). Sixteen patients (16.5%) died during the follow-up. No significant association between γ-H2AX expression and patient survival was detected. The unadjusted HR (hazard ratio) for γ-H2AX positive was 0.84 (95% CI: 0.27, 2.60). In TNM staging subgroup analysis, death only occurred in γ-H2AX negative patients. Our study is the first study to demonstrate that expression of γ-H2AX is associated with TNM staging. Due to the small sample and limited follow-up time, we did not observe a significant association between γ-H2AX and patient survival. γ-H2AX expression could be a potential biomarker for cancer diagnosis and prediction, and further studies are in need.     

妊娠哺乳期乳腺癌患者的预后情况及其影响因素分析

目的:分析妊娠哺乳期乳腺癌患者的预后情况及其影响因素。方法:将2010年1月至2012年12月期间贵州省贵阳市妇幼保健院、贵州省医科大学和贵州省肿瘤医院收治的妊娠哺乳期乳腺癌患者60例作为研究组,选择同期收治的非妊娠哺乳期乳腺癌患者60例作为对照组,比较两组5年生存率和临床病理特征,并应用单因素和多因素Logistic回归分析患者预后的影响因素。结果:研究组5年生存率为61.67%(37/60),5年无病生存率为46.67%(28/60),均低于对照组的81.67%(49/60),73.33%(44/60)(P0.05)。研究组肿瘤最大直径、腋淋巴结转移率、TNM分期为III期的比例、雌激素受体阳性率、Ki67细胞阳性率≥20%的比例均高于对照组(P0.05),两组孕激素受体阳性率比较无统计学差异(P0.05)。单因素分析显示妊娠哺乳期乳腺癌患者总生存期与肿瘤最大直径、TNM分期、Ki67细胞阳性率≥20%的比例、腋淋巴结转移率有关(P0.05)。多因素Logistic回归分析显示,TNM分期为III期、Ki67细胞阳性率≥20%、腋淋巴结转移是影响妊娠哺乳期乳腺癌患者预后的独立危险因素(P0.05)。结论:妊娠哺乳期乳腺癌患者的预后较差,TNM分期为III期、Ki67细胞阳性率≥20%、腋淋巴结转移是影响患者预后的危险因素,对于临床防治具有重要的启示作用。     

Association of cyclin-dependent kinase inhibitor 2A/B with increased risk of developing breast cancer

There is a growing body of data reporting the association of genetic alterations in chromosome 9P21 with the risk of developing cancer. In the current study, we studied the association of a genetic variant in CDKN2A/B, rs1333049, with the risk of developing breast cancer. A total of 339 participants with and without breast cancer entered to the study. Genotyping was done by the TaqMan real-time polymerase chain reaction (RT-PCR) method and gene expression analysis was ran by RT-PCR. Our data showed that the minor allele homozygote in the total population was 10%, whereas for heterozygote was 38%. The dominant genetic model demonstrated that individuals with breast cancer had advanced TNM classification. Moreover, the logistic regression revealed that individuals who had CC/CG genotypes might have an enhanced risk of developing breast cancer when compared to the holders of GG genotype (e.g., OR = 2.8; 95% CI,1.4–5.4; p = .001), after regulated for confounders; age and body mass index. Furthermore, our analysis showed that the CDKN2A/B gene was downregulated in patients (p < .001). We showed a meaningful relationship of CDKN2A/B with the risk of breast cancer, cancer, showing the importance of studies in great sample size and several centers for studying the value of the marker as a risk classification in the management of patients with breast cancer.     

Computer-aided diagnosis of breast cancer using cytological images: A systematic review

Cytological evaluation by microscopic image-based characterization [imprint cytology (IC) and fine needle aspiration cytology (FNAC)] plays an integral role in primary screening/detection of breast cancer. The sensitivity of IC and FNAC as a screening tool is dependent on the image quality and the pathologist’s level of expertise. Computer-aided diagnosis (CAD) is used to assists the pathologists by developing various machine learning and image processing algorithms. This study reviews the various manual and computer-aided techniques used so far in breast cytology. Diagnostic applications were studied to estimate the role of CAD in breast cancer diagnosis. This paper presents an overview of image processing and pattern recognition techniques that have been used to address several issues in breast cytology-based CAD including slide preparation, staining, microscopic imaging, pre-processing, segmentation, feature extraction and diagnostic classification. This review provides better insights to readers regarding the state of the art the knowledge on CAD-based breast cancer diagnosis to date.     

Automatic image segmentation of nuclear stained breast tissue sections using color active contour model and an improved watershed method

Automatic image segmentation of immunohistologically stained breast tissue sections helps pathologists to discover the cancer disease earlier. The detection of the real number of cancer nuclei in the image is a very tedious and time consuming task. Segmentation of cancer nuclei, especially touching nuclei, presents many difficulties to separate them by traditional segmentation algorithms. This paper presents a new automatic scheme to perform both classification of breast stained nuclei and segmentation of touching nuclei in order to get the total number of cancer nuclei in each class. Firstly, a modified geometric active contour model is used for multiple contour detection of positive and negative nuclear staining in the microscopic image. Secondly, a touching nuclei method based on watershed algorithm and concave vertex graph is proposed to perform accurate quantification of the different stains. Finally, benign nuclei are identified by their morphological features and they are removed automatically from the segmented image for positive cancer nuclei assessment. The proposed classification and segmentation schemes are tested on two datasets of breast cancer cell images containing different level of malignancy. The experimental results show the superiority of the proposed methods when compared with other existing classification and segmentation methods. On the complete image database, the segmentation accuracy in term of cancer nuclei number is over than 97%, reaching an improvement of 3–4% over earlier methods.     

老年乳腺癌患者的临床病理特点及其辅助治疗模式的研究

目的:探讨老年乳腺癌患者的临床病理特点及其辅助治疗模式,为老年乳腺癌患者的临床治疗提供参考。方法:选取2008年1月-2012年1月期间我院收治的50例老年乳腺癌患者作为研究对象,同时选取同期收治的50例中青年乳腺癌患者,比较两组患者的临床病理特征,并采用新辅助内分泌疗法治疗本组50例老年乳腺癌患者,治疗4个月后观察治疗效果。结果:老年乳腺癌患者的病灶5cm比例以及ER和PR阳性率均明显高于中青年患者,两组患者数据比较差异有统计学意义(P0.05);老年乳腺癌患者的淋巴结转移率、Ki67阳性率以及HER-2阳性率均低于中青年患者,两组患者数据比较差异均有统计学意义(P0.05);本组50例老年乳腺癌患者治疗总有疗效为82.0%,ER、PR均为阳性患者的治疗有效率为90.0%,明显高于ER和PR非双阳性患者(76.9%,57.1%),数据比较差异均有统计学意义(P0.05);TNM I期患者的治疗有效率为93.8%,明显高于TNM II期(76.9%)或TNM III期患者(20.0%),数据比较差异均有统计学意义(P0.05)。患者在治疗期间均未出现严重不良反应。结论:老年乳腺癌患者的生物学行为较好,病灶大、淋巴转移率低以及ER和PR阳性率高;新辅助内分泌治疗老年乳腺癌患者,尤其对ER、PR均为阳性以及TNM分期低的患者临床效果安全有效,不良反应发生率低,值得临床推广应用。