STUDY OF HISTOMORPHOLOGY AND IMMUNOHISTOCHEMICAL ANALYSIS IN BREAST NEOPLASM

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STUDY OF HISTOMORPHOLOGY AND IMMUNOHISTOCHEMICAL ANALYSIS IN BREAST NEOPLASM

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 8

Abstract

BACKGROUND Carcinoma of the breast is the most common malignant tumour and the most common cause of death from carcinoma in females all over the world. (1) The important pathological prognostic factors in invasive breast carcinoma include patient’s age, tumour size, lymph node metastasis, nuclear grade, histological grade, histological type, hormone receptor status and HER-2/neu. (2) A single parameter with the strongest prognostic significance is hormone receptor status. Aims and Objectives1. Occurrence of ER, PR and HER-2/neu in post-surgical histological specimen. 2. Expression of ER, PR and HER-2/neu receptors as per staging in carcinoma breast. 3. To co-relate histomorphological variants with immunohistochemistry. MATERIALS AND METHODS A hospital-based, prospective, observational study was conducted at Department of Surgery, MGM Medical College and MY Hospital, Indore. A total of 50 diagnosed carcinoma breast cases coming to our hospital were taken into study after informed consent. Detailed history was taken from patients and a biopsy specimen was taken from all patients. Gross examination pertaining to overall size of the specimen, nipple and areola, tumour size, margin status and nodal status were carefully studied. The tissue was processed for routine histopathological examination and stained with haematoxylin and eosin. The slides were then stained with ER, PR and HER2/neu antibodies. RESULTS Mean age of the study subjects was 54.32 years, while age at menarche and menopause was 13.12 years and 44.61 years respectively. Most common type of carcinoma seen in the present study was invasive ductal carcinoma (90%). Out of the total 50 cases, 20% and 42% were in stage I and II respectively, while 36% and 2% were in stage III and IV. Prevalence of positive oestrogen receptor, progesterone receptor and HER-2/neu status was seen in 52%, 48% and 24% cases respectively. No association was observed between age at diagnosis and parity with positive hormonal status. A significant association was observed between increasing tumour size and LN status with positive HER-2/neu and ER and PR negative status (p < 0.05). Out of the 19 cases of stage III/ IV approx. 31.6% are ER and PR+, while out of 31 cases in stage I/ II 64.5% were ER and PR positive (p < 0.01). Similarly, 22.6% cases of stage I/ II were HER-2/neu positive as compared to 21.05% of stage III and IV (p-0.27). CONCLUSION The frequency of carcinoma of breast is high in post-menopausal group. The most common tumour pathology found in the study was Ductal Carcinoma. Definitive prognostic correlation was found with ER and PR receptors. HER-2/neu expression was high in advanced diseases like axillary node positive patients. The clinical importance of these prognostic markers in the management of breast cancer in clinical practice is strongly recommended.

Authors and Affiliations

Manish Kaushal, Arvind Shukla, Pankaj Patil

Keywords

ER PR HER-2/NEU.

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EP ID EP410117
DOI 10.14260/jemds/2018/238
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