Histomorphological correlation of apoptotic index with ER/PR Status in breast
Journal Title: Medpulse International Journal of Pathology - Year 2018, Vol 6, Issue 1
Abstract
Background: Carcinoma breast is globally the most common cancer in women and second most common cause of cancer death worldwide. Predictive and prognostic indicators are used to select best treatment options. Assessment of estrogen and progesterone receptor status by immunohistochemistry is an important prognostic marker to predict survival and response to hormonal therapy. It has become the gold standard in breast carcinoma, but is expensive. Secondly, apoptotic index- a measure of the rate of death of cancer cells within a tumour, is an independent prognostic marker. It is relatively inexpensive and can be calculated from a Haematoxylin and Eosin stained slide. The present study was conducted to assess efficacy of apoptotic index in comparison to immunohistochemistry in predicting the prognosis in carcinoma breast. Methods: In all mastectomy cases, histological findings were noted along with assessment of grade and apoptotic index. Immunohistochemistry was performed in all cases. The mean apoptotic index was compared with the grades and the receptor status. Results: Grade II infiltrating ductal carcinoma was seen in most of the cases. Grade III tumours had a significantly higher mean apoptotic index (p-value =0.000). Receptor negative tumours had a significantly higher apoptotic index (p-value =0.003). Conclusion: Assessment of hormone receptors is prognostically important in breast carcinoma, but apoptotic index being a relatively inexpensive and easy procedure can also be used as an accessory tool in patients where immunohistochemistry is beyond reach. Although not a replacement of immunohistochemistry, apoptotic index can also help in predicting prognosis of patients where receptor status is not known.
Authors and Affiliations
Natasha Makkar, Anjali Khare, Rani Bansal, Nivesh Aggarwal, Shilpi Bhargava
Keywords
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