Clinicopathological and prognostic analysis of PIK3CA mutated invasive breast cancer in Chinese women

Abstract

Objective  To explore the relationship between PIK3CA mutations and clinicopathological features and prognosis in breast cancer patients.

Methods  This retrospective cohort study included 283 patients with invasive breast cancer who underwent surgery from June 2017 to June 2022. PIK3CA exon 9 and 20 mutations were detected using PCR and sequencing. Patients were divided into recurrence (n = 47) and non-recurrence (n = 236) groups based on follow-up data to identify postoperative recurrence factors and build a prediction model. Kaplan-Meier analysis was used to evaluate recurrence rates.

Results  PIK3CA mutations were identified in 41% of patients, with exon 20 mutations being the most common (62.1%). Mutations correlated with tumor quadrant, histological subtype, clinical stage, perineural invasion, and high NLR (p < 0.05). Recurrence group patients showed higher BMI, multiple tumors, non-luminal types, advanced clinical stage, lymph node metastasis, and higher NLR (p < 0.05). Multivariate analysis identified high BMI, multiple tumors, lymph node metastasis, advanced clinical stage, and perineural invasion as independent recurrence risk factors (p < 0.05). Notably, no significant difference in disease-free survival was observed between PIK3CA mutant and wild-type patients (p > 0.05).

Conclusion  PIK3CA mutations are associated with specific clinicopathological features but do not significantly impact prognosis in breast cancer patients.