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Breast cancer is a heterogeneous disease and has significant variability in presentation, treatment response, and prognosis. The management of carcinoma breast is currently based on immunophenotypes and Tumour Nodes Metastasis (TNM) staging. The aim of the study is to review the literature and to look for treatment guidelines of carcinoma breast, the role of immunophenotypes in treatment of carcinoma breast, TP53 mutation in breast cancer, and the relationship of TP53 mutation with immunophenotypes, histological grade, efficacy of chemotherapy, and BRCA (Breast Cancer gene) mutation. Pubmed database was researched and a total of 510 articles were analysed. A total of one meta-analysis, one randomised controlled trial, one literature review, nine prospective studies, and three retrospective studies were included for further analysis. It was observed that TP53 mutation is associated with poor overall survival. It was also found to be inversely associated with the Estrogen Receptor (ER) status and so it was seen more commonly in basal type and HER2/neu enriched breast cancer. There is a need for further studies to establish the definite association between TP53 and immunophenotypes so that TP53 alone can be used as a guide for management in carcinoma breast at low resource centres.

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BACKGROUNDThe breast cancer among women both in the developed and developing world is rampant, the assessment of grading system of carcinoma breast and its utility for better time-bound prognostification can significantly improve in predicting aggressive tendency of the breast cancer and also further help develop a therapeutic protocol.The aim of the study is to compare between the histopathological tumour grade with prognostic factors like age (based on menstrual status), tumour size, lymph node status and to establish histopathological grading (modified Bloom-Richardson's) as a time-bound prognostic indicator. MATERIALS AND METHODSThe present work was carried out in the histopathology and immunohistochemistry section of Department of Pathology, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi (M), Wardha, from January 2013 to July 2016. It was a prospective analytical study. A tota1 of 114 female patients presenting in the Outpatient Department of Surgery with lump in breast were included in the present study. All patients underwent modified radical mastectomy for tumour resection. Tumour masses and lymph nodes were subjected to routine H and E staining, then examined by senior pathologist. Comparisons were made between histopathology grades with patient age, tumour size and lymph node status. RESULTSThe study found that the breast carcinoma having an excellent correlation between the histopathologic grades and the wellestablished prognostic tools, i.e. tumour size, lymph node status, though age-based on menstrual status was insignificant statistically. The 'p' value was significant when correlation between histopathological grade, tumour size and lymph node status was done respectively, P=0.0001, S; P=0.0006, S, whereas the 'p' value was insignificant, i.e. P=0.18, NS when correlation between the histopathology grade and age was done. CONCLUSIONNottingham's modification of Bloom-Richardson histopathological grade being an excellent predictive prognostic tool should be continued for assessing the grades in breast cancer patients as well as be incorporated at the clinical level with the tumour size, nodal involvement, metastasis (TNM) staging of breast cancers.