Immunohistochemical profile and its association with clinicopathological parameters in carcinoma breast: a prospective study in central India

Authors

  • Vaishali Walke Department of Pathology, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
  • Gajanan Gunjkar Department of Pathology, District Hospital, Alibagh, Raigad, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20191679

Keywords:

Breast carcinoma, Histological grade, Immuno histochemistry, Molecular classification, Triple negative

Abstract

Background: Carcinoma breast is one of the most common malignancies of women in India. The current study was conducted with the objective of assessing estrogen receptor (ER), progesterone receptor (PR), Her-2/neu (human epidermal growth factor receptor-2) expression and Ki67 index of breast carcinomas and its correlation with histological grade, tumour size and lymph node metastasis.

Methods: Forty-seven lumpectomy or modified mastectomy specimens diagnosed as Infiltrating duct carcinoma (IDC): NOS, were selected for panel of imuno histochemistry (IHC) markers on tissue microarray blocks prepared from each case.

Results: Maximum of our patients belonged to premenopausal 24/47 (51%) and 20% to younger age group (<30 year). Tumour size of 2-5 cm was observed in maximum females 29 (61%); while 13(27%) had size >5.0cm. The majority of cases diagnosed as grade I (40%) and lymph node involvement was seen in 31/47 (65%). Molecular classification revealed 10 (21%) luminal A, 4 (8%) luminal B, 9 (19%) Her2/neu positive, while triple negative phenotype comprised of maximum 24 (51%) patients. Most of the Luminal group tumours were low grade (14/15); while majority of Her2/neu positive 7/9(77%) and triple negative tumours 19/24 (80%) belonged to higher grades.

Conclusions: Breast carcinoma among our patient is characterized by a large percentage of triple negative phenotype that is less susceptible to hormonal therapy. The empirical treatment with tamoxifen should therefore be reconsidered as it would be less effective. Assessment of prognostic markers in breast carcinoma is strongly advocated in order to provide the best therapeutic options.

References

Devita VT, Hellman S, Rosenberg A, eds. Cancer-principles and practice of oncology 6th ed. William and Wilkins Philadelphia; 2001:1687.

Stewart B, Kleihues P. World cancer report. IARC Press Lyon; 2003:191.

Nandakumar A, Ramnath T, Chaturvedi M. The magnitude of cancer breast in India: a summary. Indian J Surg Oncol. 2010;1(1):8-9.

Ambroise M, Ghosh M, Mallikarjuna VS, Kurian A. Immunohistochemical profile of breast cancer patients at a tertiary care hospital in South India. Asian Pac J Cancer Prev. 2011;12(3):625-9.

Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, et al. Race, breast cancer subtypes, and survival in the carolina breast cancer study. JAMA. 2006;295(21):2492-502.

Mohammadian K, Pashaki AS, Hamed EA, Behnood S, Abassi M, Babaei M, et al. Association between immuno histochemical profile and clinicopathological appearance in breast cancer: A 7-year review from mahdieh radiotherapy center, hamadan, Iran. Rep Radioth Oncol. 2013;1(3):103-7.

Atchley DP, Albarracin CT, Lopez A, Valero V, Amos CI, Gonzalez-Angulo AM, et al. Clinical and pathologic characteristics of patients with BRCA-positive and BRCA-negative breast cancer. J Clinic Oncol: Offic J Am Soci Clinic Oncol. 2008;26(26):4282-8.

Siddiqui B, Piyush AR, Faridi SH, Ahmad SS, Khan R. Trends in molecular classification of breast carcinoma in a tertiary health care centre: A 5-year retrospective study. Int Arch BioMed Clin Res. 2016;2(2):69-72

Cheang MC, Voduc D, Bajdik C, Leung S, McKinney S, Chia SK, et al. Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. Clinic Canc Res. 2008;14(5):1368-76.

Sørlie T, Wang Y, Xiao C, Johnsen H, Naume B, Samaha RR, et al. Distinct molecular mechanisms underlying clinically relevant subtypes of breast cancer: gene expression analyses across three different platforms. BMC Genomics. 2006;7(1):127.

Fan C, Oh DS, Wessels L, Weigelt B, Nuyten DS, Nobel AB, et al. Concordance among gene-expression- based predictors for breast cancer. New Eng J Med. 2006;355(6):560-9.

Nielsen TO, Hsu FD, Jensen K, Cheang M, Karaca G, Hu Z, et al. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clinic Can Res. 2004;10(16):5367-4.

Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, Vijver MJ. WHO classification of tumours of breast. IARC Lyon. 2012:14-38.

Fitzgibbons PL, Dillon DA, Alsabeh R, Berman MA, Hayes DF, Hicks DG, et al. Template for reporting results of biomarker testing of specimens from patients with carcinoma of the breast. Archiv Pathol Lab Med. 2013;138(5):595-601.

Patnayak R, Jena A, Rukmangada N, Chowhan AK, Sambasivaiah K, Phaneendra BV, Reddy MK. Hormone receptor status (estrogen receptor, progesterone receptor), human epidermal factor-2 and p53 in south Indian breast cancer patients: A tertiary care center experience. Indian J Med Paediatr Oncol. 2015;36(2):117-22.

Inwald EC, Klinkhammer-Schalke M, Hofstadter F, Zeman F, Koller M, Gerstenhauer M, et al. Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry. Breast Canc Res Treat. 2013;139(2):539-52.

Haroon S, Hashmi AA, Khurshid A, Kanpurwala MA, Mujtuba S, Malik B et al. Ki-67 index in breast cancer: correlation with other prognostic markers and potential in Pakistani Patients. Asian Pac J Canc Prevent. 2013;14(7):4353-8.

Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Parmar V, et al. Hormone receptors over the last 8 years in a cancer referral centre in India: What was and what is. Indian J Pathol Microbiol. 2009;52(2):284-90.

Azizun-Nisa, Bhurgri Y, Raza F, Kayani N. Comparison of ER, PR and HER-2/neu (C-erb B2) reactivity pattern with histologic grade, tumour size and lymph node status in breast cancer. Asian Pac J Cancer Prev. 2008;9(4):553-6.

Sandhu DS, Sandhu S, Karwasra RK, Marwah S. Profile of breast cancer patients at a tertiary care hospital in north India. Indian J Canc. 2010;47(1):16-22.

Pakseresht S, Ingle GK, Bahadur AK, Ramteke VK, Singh MM, Garg S et al. Risk factors with breast cancer among women in Delhi. Indian J Canc. 2009;46(2):132-8.

Sofi GN, Sofi JN, Nadeem R, Shiekh RY, Khan FA, Sofi AA et al. Estrogen receptor and progesterone receptor status in breast cancer in relation to age, histological grade, size of lesion and lymph node involvement. Asian Pacific J Canc Prevent. 2012;13(10):5047-52.

Geethamala K, Murthy SV, Vani BR, Sudha R. Histopathological grade versus hormone receptor status in breast carcinoma-treasure the past. Int J Biomed Res. 2015;6(7):466-71

Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF. Hormone receptor status of breast cancer in India: A study of 798 tumors. Breast 2000;9(5):267-0.

Rilke F, Colnaghi MI, Cascinelli N. Prognostic significance of HER-2/neu expression in breast cancer and its relationship to other prognostic factors. Int J Canc. 1991;49(1):44-9.

Hoff ER, Tubbs RR, Myles JL. HER2/neu amplification in breast cancer: stratification by tumor type and grade. Am J Clin Pathol. 2002;117(6):916-21

Vaidyanathan K, Kumar P, Reddy CO, Deshmane V, Somasundaram K, Mukherjee G. ErbB-2 expression and its association with other biological parameters of breast cancer among Indian women. Indian J Cancer. 2010;47(1):8-15.

Ghosh J, Gupta S, Desai S, Shet T, Radhakrishnan S, Suryavanshi P et al. Estrogen, progesterone and HER2 receptor expression in breast tumours of patients, and their usage of HER2-targeted therapy, in a tertiary care centre in India. Indian J Cancer. 2011;48(4):391-96.

Onitilo AA, Engel JM, Greenlee RT, Mukesh BN. Breast cancer subtypes based on ER/PR and Her2 expression: comparison of clinicopathologic features and survival. Clin Med Res. 2009;7(1-2):4-13.

Kumar N, Mukherjee S. Correlation of various prognostic factors in breast cancer. Int J Scient Res Publicat. 2013;3(8):2250-3.

Pandey S, Pandey D. Immunohistochemical profile of invasive breast carcinoma patients: a study at tertiary care hospital in central India. Indian J Res. 2017;6(9):44-6

Luangxay T, Virachith S, Hando K, Vilayvong S, Xaysomphet P, Arounlangsy P, et al. Subtypes of breast cancer in Lao PDR: a study in a limited-resource setting. Asian Pacific J Canc Prevent. 2019;20(2):589-4.

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Published

2019-04-26

How to Cite

Walke, V., & Gunjkar, G. (2019). Immunohistochemical profile and its association with clinicopathological parameters in carcinoma breast: a prospective study in central India. International Journal of Research in Medical Sciences, 7(5), 1796–1802. https://doi.org/10.18203/2320-6012.ijrms20191679

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Original Research Articles