Correlation of Her-2/neu Status With Estrogen, Progesterone Receptors and Histologic Features in Breast Carcinoma
Keywords:
Breast carcinoma, Her-2/neu, ER/PR.
Abstract
Background: Breast cancer is the commonest cancer in urban Indian females, and the second commonest cancer in the rural Indian women. One of the hallmark of the disease is expression of Estrogen Receptor (ER), Progesterone Receptor (PR) and Her-2/neu that ultimately drives prognosis & treatment modalities.Aims: This study is to evaluate the expression of ER and PR and Her-2/neu in Breast Carcinoma & to compare them with other prognostic parameters: histological type and grade, tumor size, patients' age and lymph node metastases.Method: 80 cases of Invasive Breast Carcinoma received as MRM (Modified Radical Mastectomy) over a period of 6-8 months were included. Routine H&E staining and IHC analysis for ER, PR and Her-2/neu was carried out in all cases.Result: Out of 80 cases, 69 (86%) cases were of Infiltrating Ductal Carcinoma with mean age of 53 years. ER, PR & Her-2/neu expression were seen in 56.9%, 35.5% & 21.3% respectively. ER, PR expressing tumours tend to be of lower grade I(p<0.05). 94.1% Her-2/neu expressing tumours presented with higher tumour grade (II, III) but statistically not significant. Lymph node metastases was found to be significantly associated with PR and Her-2/neu positive status (p=0.03, p=0.01 respectively). Her-2/neu expression was inversely related to ER and PR expression (p<0.05).Conclusion: Higher number of grade 1 tumors showed ER, PR positivity as compared to grade 3 tumors. Inverse relationship was observed between Her-2/neu expression and ER, PR receptor status. Her-2/neu expression was associated with higher rate of axillary metastasis but did not show any significant correlation with age, tumour size and grade.References
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28. Arafah M. Correlation of Hormone Receptors with Her 2/neu Protein Expression and the Histological Grade in Invasive Breast Cancers in a Cohort of Saudi Arabia. Turkish Journal of Pathology. 2010; 26(3):209-215.
29. Mahmoud S Al-Ahwal. HER-2 Positivity and Correlations with other Histopathologic Features in Breast Cancer Patients - Hospital Based Study. J Pak Med Assoc. 2006; 56(2):65-68.
2. Harrison AP, Srinivasan K, Binu VS, Vidyasagar MS, Nair S. Risk factors for breast cancer among women attending a tertiary care hospital in southern India. Int J of Collaborative Research on Internal Med & Pub Health. 2010; 2(4):109-116.
3. Rampaul RS, Pinder SE, Elaston CW, Ellis IO. Prognostic and predictive factors in primary breast cancer and their role in patient management; the Nottingham breast team. Eur J Surg Oncol. 2001; 27: 229-238.
4. Kaptain S, Tan LK, Chen B. Her-2/neu and breast cancer. Diagn Mol Pathol. 2001;10:139-152.
5. Bundred NJ. Prognostic and predictive factors in breast cancer. Cancer Treat Rev. 2001;27:137-142
6. Sastre-Garau X, Jouve M, Asselain B, et al. Infiltrating lobular carcinoma of the breast; clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns. Cancer. 1996;77:113-120.
7. Zafrani B, Aubriot MH, Mouret E, et al. High sensitivity and specificity of immunohistochemistry for the detection of hormone receptors in breast carcinoma: comparison with biochemical determination in a prospective study of 793 cases. Histopathology. 2000;37:536-545.
8. Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol. 1998; 11:155-168.
9. Early Breast Cancer Trialists' Collaborative Group. Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet. 1998; 351:1451-1467.
10. Hanna W, Kahn HJ, Trudeau M. Evaluation of Her-2/neu (erbB- 2) status in breast cancer: from bench to bedside. Mod Pathol.1999; 12:827-834.
11. Hortobagyi GN. Overview of treatment results with trastuzumab (Herceptin) in metastatic breast cancer. Semin Oncol. 2001; 28:43-47.
12. McKeage K, Perry CM. Trastuzumab: a review of its use in the treatment of metastatic breast cancer overexpressing HER2. Drugs. 2002; 62:209-243.
13. Rosai J. Breast. In: Houston M, Scott J, editors. Rosai and Ackerman’s Surgical Pathology. 10th ed (2). Missouri: Elsevier; 2012:1696-1720.
14. Elston CW. Grading of invasive carcinoma of the breast. In: Page DL, Anderson TJ, editors. Diagnostic histopathology of the breast. Churchill Livingston;1987: 300-311.
15. Tavassoli FA, Devilee P. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs Lyon. IARC, in press; 2004.
16. Barnes DM, Hanby AM. Oestrogen and progesterone receptors in breast cancer: past, present and future. Histopathology. 2001;38: 271-274.
17. Hilf R, Feldstein ML, Savlov ED, Gibson SL, Seneca B. The lack of relationship between estrogen receptor status and response to chemotherapy. Cancer.1980; 46: 2797-2800.
18. Jakesz R, Hausmaninger H, Kubista E, Gnant M, Menzel C, Bauernhofer T, et al. Randomized adjuvant trial of tamoxifen and goserlin versus cyclophosphamide, methotrexate and fluorouracil: evidence for the superiority of treatment with endocrine blockade in premenopausal patients with hormone responsive breast cancer - Austrian Breast and Colorectal Cancer Study Group. J Clin Oncol. 2002;20:4621-4627.
19. Azizun N, Yasmin B, Farrukh R, Naila K. Comparison of ER, PR & Her-2/neu (C-erb B) Reactivity Pattern with Histologic Grade, Tumor Size and Lymph Node status in Breast Cancer. Asian Pacific Journal of Cancer Prevention. 2008; 9:553-556.
20. Nidal MA, Mohammad AH. Immunohistochemical evaluation of human epidermal growth factor receptor 2 and estrogen and progesterone receptors in breast carcinoma in Jordan. Breast Cancer Research. 2005; 7 (5): 598-604.
21. Pathak TB, Bashyal R, Pun CB, Shrestha S, Bastola S, Neupane S, Poudel BR, Lee MC. Estrogen and progesterone receptor expression in breast carcinoma. Journal of Pathology of Nepal. 2011; 1: 100-103.
22. Fatima S, Faridi N, Gill S. Breast cancer. Steroid receptors and other prognostic indicators. J Coll Physicians Surg.2005; 15: 230-233.
23.Bhagat VM, Jha BM, Patel PR. Correlation of hormonal receptor and Her-2/neu expression in breast cancer: a study at tertiary care hospital in south Gujarat. National Journal Of Medical Research.2012; 2( 3):295-298.
24. Lal P, Lee K et al. Correlation of HER-2 Status With Estrogen and Progesterone Receptors and Histologic Features in 3,655 Invasive Breast Carcinomas. Am J Clin Pathol. 2005; 123:541- 546.
25. Ashba J, Traish AM. Estrogen and progesterone receptor concentrations and prevalence of tumor hormonal phenotypes in older breast cancer patients. Cancer Detect Prev. 1999; 23:238-244.
26. Eppenberger-Castori S, Moore DH, Thor AD, Edgerton SM, Kueng W, Eppenberger U, et al. Age-associated biomarker profiles of human breast cancer. Int J Biochem Cell Biol. 2002; 34: 1318-1330.
27. Hoff ER, Tubbs RR, Myles JL, Procop GW. HER2/neu amplification in breast cancer: stratification by tumor type and grade. Am J Clin Pathol. 2002; 117:916-921.
28. Arafah M. Correlation of Hormone Receptors with Her 2/neu Protein Expression and the Histological Grade in Invasive Breast Cancers in a Cohort of Saudi Arabia. Turkish Journal of Pathology. 2010; 26(3):209-215.
29. Mahmoud S Al-Ahwal. HER-2 Positivity and Correlations with other Histopathologic Features in Breast Cancer Patients - Hospital Based Study. J Pak Med Assoc. 2006; 56(2):65-68.
Published
2016-11-08
Section
Original Article
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