A Study of Prognostic Factors in Carcinoma Breast

Abstract

BACKGROUND Cancer of the breast in women is a major health burden worldwide. It is the most common cause of cancer among women and is responsible for over one million of the estimated 10 million neoplasms diagnosed worldwide each year in both sexes Traditional prognostic factors include the axillary lymph node status, the tumour size, nuclear grade, histological grade and lymphatic and vascular invasion. There are studies that have evaluated time trends in stage specific breast cancer survival rates according to joint ER/PR status along with some other molecular markers like HER2/neu. It has been shown that these parameters together might have the ability to further help in identifying treatment gaps where progress could be made in order to increase the treatment outcome. It has been shown that screening helps to identify early stage breast cancer; 1 however there are studies that have evaluated time trends in stage specific breast cancer survival rates according to joint ER/PR status and HER2/neu. With this background, the present study was planned with an aim to evaluate the role of various traditional (number of positive axillary nodes, tumour size, tumour grade, lymphatic and vascular invasion) as well as newer (ER/PR), HER2/neu prognostic indicators of breast cancer. MATERIALS AND METHODS The prospective observational study was done in the department of general surgery in Era's Lucknow Medical College, Lucknow, from January 2017 to June 2018. Biopsy proven patients of breast carcinoma admitted to Department of Surgery, were included in the study. A total of 80 women with breast cancer, falling in sampling frame, were enrolled in the study and were followed up for six months. The primary outcome was survival and recurrence free survival. Various demographic, clinical, medical, personal and obstetric history factors, FNAC/biopsy findings, USG findings and hormonal assessments, viz., ER, PR and HER2/neu assessments were evaluated for their prognostic role. During the course of study (six months follow-up), no death took place; however, recurrence was noted in 12 (15%) cases. For this purpose, a total of 80 women with stage 2 or above breast cancer scheduled to undergo modified radical mastectomy following the neoadjuvant chemotherapy falling in sampling frame were enrolled in the study and were followed up for six months. RESULTS During the six months' follow-up, there was no mortality and no case of metastasis was noted. However, recurrence was seen in a total of 12 (15%) cases. Thus, recurrence rate was 15% in present study. CONCLUSIONS Hormonal markers ER/PR/HER2/neu were the most important prognostic markers for outcome at six months.