Breast cancer (BC) is the first leading cause in the structure of cancer among women. According to the World Health Organization, about 1.38 million new cases of this cancer are diagnosed every year. BC is the leading cause of death among women 35-54 years old is which reaches 20%, and among women after 55 – becomes at the second place of mortality after cardiovascular disease. In recent years, mortality from breast cancer in Ukraine is the leading cause of death among all cancers (17.3%) and has been increasing in absolute and relative terms (16.5 per 100 thousand women in 2016).
The Thesis is devoted to the study of morphological features of clinical and morphological, immunohistochemical features of breast cancer and their regional lymph nodes to improve the treatment results of patients by personification of therapy.
The material was presented in 300 cases of primary breast cancer and regional metastases. The results of combined and complex treatment of locally advanced BC were studied in 141 cases of BC. The main clinical and morphological features of BC were taken into account, namely: age of patients, results of computed tomography, histological type of the tumor structure, tumor differentiation, mitotic activity, presence of extention intraductal component (EIC), immunohistochemical characteristics of primary tumor and lymph node metastases with investisation of the steroid hormone receptors – expretion of ER and PR, proliferation activity - Ki-67, human epidermal growth factor Her-2 / neu according to the molecular biological classification of BC, the marker topoisomerase II-alpha, which is a target of anthrocycline antibiotics used in chemotherapy of BC and class III beta-tubulin – a structural element of the microtubules of cytoskeletal tumor cells component.
Two study groups were formed: the first group (comparison) – 82 patients who received neoadvant polychemotherapy (NAPCT) according to the scheme DC (docetaxel + cyclophosphamide) 4-6 courses, and adjuvant treatment was prescribed according to the obtained postoperative histological findings. The second group (the main) included 59 patients who were received NAPCT according to the DDC scheme (docetaxel + doxorubicin + cyclophosphamide), and adjuvant treatment was prescribed according to the biological type of tumors and metastases of lymph nodes, as well as additional immunohistochemical determination of metastases in lymph nodes for tumor type identification (ER, PR, Her2neu, Ki-67) and determination of markers of topoisomerase II alpha and class III beta-tubulin.
The mean age of patients at the time of diagnosis was 49.1 ± 10.8 (27 to 78) years old. Recurrence-free survival rates among the reproductive and menopausal groups were 73.3% and 92.2%, respectively (p > 0.05). Reproductive status also had no significant effect on overall survival (p > 0.05). As a result of investigation of the age influences, there are significant differences in survival rates in two age groups – younger than 40 years and older than 40 – were found: recurrence-free survival in the younger age group was significantly lower than in the older (78.8% and 92.1%, respectively, p<0.05). Overall survival rates were also lower in patients younger than 40 years than in the older age group (73.4% and 89.5%, respectively, p<0.05).
