Comparison of ER, PR and HER-2/NEU reactivity pattern with histological grade, type, tumour size, Lymphovascular invasion, mitotic index and lymph node status in breast cancer

Abstract

Breast cancer prognosis is related to a variety of clinical, pathologic and molecular features which include classical prognostic factors viz. Histological grade, morphological type, tumour size, mitotic index, Lymphovascular invasion and lymph node metastases. Estrogen and progesterone receptors (ER, PR) and more recently, HER-2/neu have with increasing importance influenced the management of the malignancy. The presence of hormone receptors (ER and PR) in the tumour tissue correlates well with the response to hormone therapy and chemotherapy. Aims: To assess ER, PR and Her2neu status in breast cancer and to compare ER, PR and Her2neu status with other prognostic factors like tumour size, pathological type, histological grade, lymph node status, mitotic index and Lymphovascular invasion in breast cancer. Methods and materials: A total of 100 cases of breast cancer reported at pathology department during a period from January 2019 to August 2020 are enrolled in the study. Representative sections with tumour and the adjacent normal breast tissue (internal control) are processed for ER, PR and HER-2/neu immuno-histochemical staining. Tumour size, morphological type, Histological grading, Mitotic index, Lymphovascular invasion, Lymph Node status were studied. Results: Occurrence of breast carcinoma is higher in older women (> 50 years of age). The prevalence of ER, PR, HER-2/neu expression are high (ER-73.0%, PR -65.0% and HER-2/neu -28.0%). About 14.0% tumour are triple negative. Increased HER2/neu positivity is noticed in ER and PR negative tumours. Two third (66.0%) tumour's size is from 2 to 5 cm. Proportion of Grade II (39.0%) and Grade III tumour (37.0%) are high. Most common pathologic type of carcinoma is Infiltrating duct carcinoma, not otherwise specified (85.0%) followed by Mucinous carcinoma (5.0%), Invasive papillary carcinoma (4.0%) and Invasive lobular carcinoma (2.0%). PR positivity is increased with increasing tumour size. (p value = 0.01). PR positivity decreases with the increase in grade. (p value = 0.03). HER/ 2neu expression decreased with rising age. (p value = 0.03). Conclusion:The findings suggest that women in our population more often have histologically less aggressive breast carcinoma with a smaller number of triple negative tumours (14%), so they are likely to be more susceptible to conventional hormonal and targeted antibody treatment.