A study of correlation of expression of ER, PR and HER2/neu receptor status with clinico-pathological parameters in breast carcinoma at a tertiary care centre
Keywords:
Breast carcinoma, Clinicopathological parameters, Hormonal status, Triple negative casesAbstract
Background: In English literature it is documented that the expression of ER and PR is low in Asian countries when compared to that of Western countries. HER2/neu over expression is uniform throughout the world. Studies have shown that triple-negative breast carcinomas are aggressive, likely to spread beyond the breast and recur after treatment. Aims and objectives: To correlate the expression of ER, PR and HER 2/neu with clinico-pathological parameters in infiltrating ductal carcinoma and other variants of breast carcinoma. To determine the clinicopathological parameters in triple negative cases.
Methods: This is a prospective study for a period of two years in the Department of Pathology, Andhra Medical College, a tertiary care centre. We received 111 mastectomy specimens during this period out of which 52 patients were funded under Arogyasri and were subjected for ER, PR, HER2/neu receptor study.
Results: In the present study total cases analyzed were 52. Infiltrating ductal carcinoma was 41/52 (78.84%) and other variants were 11/52 (21.15%). In our institute infiltrating duct cell carcinoma (NOS) type was the commonest type of carcinoma breast with significant group occurring in less than 45 years of age, 95 % of women were multipara with two or more children and triple negative tumors being 54.83%.In infiltrating ductal carcinoma ER, PR positive expression has no association with age and size of tumor. Their expression was higher in grade 1 tumors 83.3%.The ER,PR negative expression was more in size of tumor being greater than 2 cm; (92.5%),positive lymph nodes (51.8%) and stage II and stage III tumors (96.2%). HER2/neu negative expression was seen in 51.61% of cases. Triple negative receptor expression was seen in 54.83% of infiltrating ductal carcinoma. In the English literature medullary carcinoma is negative for HER2/neu expression but in the present study in 2 cases the expression for HER2/neu was positive.
Conclusion: In the present study significant group occurred in less than 45 years of age presenting in advanced stage of the disease. Triple negative cases were seen in 54.8% cases of infiltrating duct cell carcinoma indicating bad prognosis.
References
Lobna Ayadi, Abdelmajid Khabir, Habib Amouri, Sondes Karray, Abdallah Dammak, Mohamed Guermazi, et al. Correlation of HER-2 over-expression with clinico-pathological parameters in Tunisian breast carcinoma. World J Surg Oncol. 2008;6:112.
Raina V, Bhutani M, Bedi R, Sharma A, Deo SV, Shukla NK, et al. Clinical features and prognostic factors of early breast cancer at a major cancer center in North India. Indian J Cancer. 2005 Jan-Mar;42(1):40-5.
Sunita Saxena, Bharat Rekhi, Anju Bansal, Ashok Bagga, Chintamani, Nandagudi S. Murthy. Clinico-morphological patterns of breast cancer including family history in a New Delhi hospital, India: a cross-sectional study. World J Surg Oncol. 2005;(3):67.
Lokuhetty MDS, Ranaweera GG, Wijeratne MD, Sheriffdeen SH. Profile of breast cancer in a group of women in a developing country in South Asia: is there a difference? World J Surg. 2009 Mar;33(3):455-9.
Lakmini KB. Mudduwa. Quick score of hormone receptor status of breast carcinoma: correlation with the other clinico-pathological prognostic parameters. Indian J Pathol Microbiol. 2009;52:159-63.
Zubair Ahmad, Amna Khurshid, Asim Qureshi, Romana Idress, Nasira Asghar, Naila Kayani. Breast carcinoma grading, estimation of tumor size, axillary lymph node status, staging, and Nottingham prognostic index scoring on mastectomy specimens. Indian J Pathol Microbiol. 2009;52:477-81.
Park S, Kim JH, Koo J, Park BW, Lee KS. Clinico-pathological characteristics of male breast cancer. Yonsei Med J. 2008 Dec;49(6):978-86.
Mohd Shafi Moona, Ramah Al, Rameh Alarabi, Arshad Hussain, Mahmood Ahmed, Itrat Mehdi. The study of ER,PR and HER-2/neu status in patients with breast cancer. JMJ. 2010;10:141-3.
Adedayo A. Onitilo, Jessica M. Engel, Robert T. Greenlee, Bickol N. Mukesh. Breast cancer subtypes based on ER/PR and HER2 expression: comparison of clinico-pathologic features and survival. Clin Med Res. 2009 Jun;7(1-2):4-13.
Thike AA, Cheok PY, Jara-Lazaro AR, Tan B, Tan P, Tan PH. Triple-negative breast cancer: clinico-pathological characteristics and relationship with basal-like breast cancer. Mod Pathol. 2010 Jan;23(1):123-33.
Suraj Manjunath, Jyothi S. Prabhu, Rohini Kaluve, Marjorie Correa, T. S. Sridhar. Estrogen receptor negative breast cancer in India: do we really have higher burden of this subtype? Indian J Surg Oncol. 2011;2(2):122-5.
Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol. 1998;11:155-68.
