Correlation of Receptor Status With Axillary Nodal Metastasis and Other Prognostic Factors in Carcinoma Breast : Indian Perspective

Abstract

Background- nd Breast cancer is the 2 most common cancer globally and it ranks rst in India. The predictive value of various components like hormone receptor status, tumor size, grade to axillary lymph nodal metastasis has been studied previously. Our aim is to study the correlation of receptor status and axillary lymph nodal metastasis in breast cancer patients. Methods- This is a retrospective study carried out in single surgical unit. 104 biopsy proven unilateral breast cancer patients who underwent modied radical mastectomy has been reviewed. The clinicopathological data has been collected from hospital records. Results- The mean age of presentation is 42.2years. Most common age group is 30-49years with clinical stage III(65.38%) with inltrating ductal carcinoma(99.03%). Although axillary lymph node was palpable in 75%, nodal metastasis is present in 63.46% of patients. Positive estrogen receptor, progesterone receptor and Her2 receptors are seen in 45.19%, 34.6% and 59.61% patients respectively. TNBC patients has least while triple positive has maximum nodal metastasis in our study group. Perineural invasion and extra capsular extension is seen in 15.38% each and lymphovascular invasion is seen in 38.4% patient. Although LVI, PNI and ECE is predominant in Her2-enriched subtypes, most patients belonging to HR+/Her2+ subtypes has LVI, PNI and ECE. TNBC and HR+/Her2- subtypes has least LVI, PNI and ECE. Conclusion- Receptor status has signicant role in predicting nodal metastasis. TNBC, although considered most aggressive, has least axillary nodal metastasis suggesting less lymphatic involvement and less LVI, PNI and ECE. Also Her2 over-expression seems to be related to nodal metastasis, LVI, PNI and ECE, suggesting there may be some pathway which is still unrevealed. Thus Her2 receptor positivity can be considered as an independent poor prognostic factor.