PATHOHISTOLOGICAL AND CLINICAL FEATURES OF BREAST CANCER DIAGNOSED IN UNIVERSITY HOSPITAL OF SPLIT IN THE PERIOD FROM 2017 TO 2020

Cilj istraživanja: Cilj istraživanja je analizirati kliničke i patohistološke osobitosti, način liječenja i odgovor na neoadjuvantno liječenje u novootkrivenim karcinomima dojke dijagnosticiranih u četverogodišnjem razdoblju od 2017. do 2020. godine u Kliničkom zavodu za patologiju, sudsku medicinu i citologiju KBC Split. Materijali i metode: U ovo istraživanje uključena je analiza 1095 patohistološka nalaza u kojima je potvrđena dijagnoza novotkrivenog invazivnog karcinoma dojke. Analizirani su slijedeći parametri: godina postavljanja dijagnoze, dob, najveći promjer tumora (osim u slučajevima kada je uzorak na temelju kojeg je postavljena dijagnoza dobiven biopsijom), podatak o postojanju inicijalno metastatske bolesti, načinu liječenja (primarno kirurški ili neoadjuvantno), broj nađenih tumora, zahvaćanje jedne ili obje dojke, najveća veličina tumora, histološki tip, imunofenotip, vrsta operativnog zahvata na limfnim čvrovima, klinički stadij i patohistološki odgovor na neoadjuvantno liječenje kod bolesnica kod kojih je nakon takvog liječenja napravljen operativni zahvat. Rezultati: U KBC-u Split od 2017. do 2020. godine dijagnosticirano je 1095 novootkrivenih invazivnih karcinoma dojke. Najviše slučajeva (26,3%) je dijagnosticirano 2020. godine. Najveći broj karcinoma dojke (31,5%) dijagnosticirano je u dobnoj skupini od 60 do 69 godina. Većina tumora (70,9%) je liječena primarno kirurški, a najzastupljeniji su bili tumori u kategoriji T1c. Najučestaliji histološki tip u skupini operativno liječenih tumora bio je invazivni NOS. Prema imunofenotipu najzastupljeniji su hormon pozitivni, Her2 negativni tumori (luminalni A i B) koji su nađeni u 83,2% operiranih tumora. Za procjenu statusa limfnih čvorova najčešće se koristila SLNB (56%) slučajeva. Najveći broj operiranih tumora je pripadao T1cN0 kategoriji, njih 35,8%. 88,3% operativno liječenih tumora je bilo ranog kliničkog stadija (klinički stadij I i II). Od ukupnog broja novodijagosticiranih tumora 8,6% je u trenutku postavljanja dijagnoze imalo diseminiranu bolest, a 38,5% je liječeno neoadjuvantno. Od 92 tumora kod kojih se može pratiti odgovor na neoadjuvantno liječenje, patološki kompletni odgovor je imalo 88,9% HER2+ tumora, 57,9% HER2 pozitivnih luminalnih B tumora, 38,9% trostruko negativnih tumora, 2,9% luminalnih B tumora i niti jednan tumor luminalnog A imunofenotipa. Zaključak: Od ukupnog broj novodijagnosticiranih tumora dojke od 2017. do 2020. godine uočava se blagi porast novodijagnosticiranih karcinoma dojki u KBC-u Split. Rezultati analize demografskih, patohistoloških i kliničkih osobitosti tumora, kao i odgovor na neoadjuvantno liječenje usporedivi su s rezultatima dobivenim u drugim epidemiološkim studijama u kojima su provedena slična istraživanja.OBJECTIVES: The aim of this study is to analyze clinical and pathohistological features, treatment and response to neoadjuvant treatment in newly found breast cancers diagnosed in the four-year period from 2017 to 2020 at the Clinical Department of Pathology, Forensic Medicine and Cytology of the University Hospital of Split. PATIENTS AND METHODS: This study included an analysis of 1095 pathohistological findings confirming the diagnosis of newly diagnosed invasive breast cancer. The following parameters were analyzed: year of diagnosis, age, largest tumor diameter (except in the cases where the sample on which the diagnosis was made was obtained by biopsy), data on the presence of initial metastatic disease, treatment (primarily surgical or neoadjuvant), number of tumors found, involvement of one or both breasts, largest tumor size, histological type, immunophenotype, type of lymph node surgery, clinical stage and pathohistological response to neoadjuvant treatment in patients who underwent surgery after such treatment. RESULTS: From 2017 to 2020, 1,095 newly diagnosed invasive breast cancers were found at the University Hospital of Split. Most cases (26.3%) were diagnosed in 2020. The highest number of breast cancers (31.5%) was diagnosed in the age group of 60 to 69 years. The majority of tumors (70.9%) were treated primarily surgically, and the most common were tumors in the T1c category. The most common histological type in the group of surgically treated tumors was invasive NOS. According to the immunophenotype, the most common are hormone positive, Her2 negative tumors (luminal A and B) with luminal A tumors which make up 83.2% of the operated tumors. SLNB (56%) was most commonly used to assess lymph node status. The largest number of operated tumors belonged to the T1cN0 category, 35.8% of them. 88.3% of surgically treated tumors were in the early clinical stage (clinical stages I and II). Of the total number of newly diagnosed tumors, 8.6% had disseminated disease at the time of diagnosis, and 38.5% were treated neoadjuvant. Of the 92 tumors in which the response to neoadjuvant treatment can be monitored, the pathological complete response had 88.9% HER2 + tumors, 58.9% HER2 positive luminal B tumors, 38.9% triple-negative tumors, 2.9% luminal B tumors and no one luminal A tumors.CONCLUSION: Of the total number of newly diagnosed breast tumors from 2017 to 2020, there is a slight increase in newly diagnosed breast cancers in the Univerity Hospital of Split. The results of the analysis of the demographic, pathohistological and clinical features of the tumor, as well as the response to neoadjuvant treatment are comparable to the results obtained in other epidemiological studies in which similar research has been conducted