ABSTRACT
Background: Breast cancers have been subclassified on the basis of molecular expression. This study evaluates the receptor expression in breast carcinoma by immunohistochemistry and classifies them into various subtypes. A comparison with other regions was also made. Methods: This prospective study included all the patients of breast carcinoma who had undergone the surgical treatment of mastectomy at SMSMC from January 2014 to June 2017. Immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) was studied and subtypes were determined. Comparison of the receptor expression and patterns was done in different age groups and with other regions. Results: ‘A total of 496 cases were included in this study. The mean age at diagnosis was 48.2 years. Most of the patients (60.3%) were less than 50 years old whereas 39.7% were above 50 years. By Bloom Richardson scoring 28.7%, 56.8% and 14.5% tumours were classified as Grade I, Grade II and Grade III respectively. ER, PR and HER2neu receptor positivity was seen in 57.5%, 44.1% and 26.6% respectively. The most common molecular subtype was luminal A (41.7%) followed by triple negative subtype (30.8%). Luminal B and HER2neu overexpressing types were 15% and 12.5% respectively. Conclusion: Immunohistochemical markers act as surrogate markers for molecular classification of breast cancers. Hormone receptor expression at our institute was comparable with other studies from India. Luminal A is the most common occurring subtype of breast cancer presenting at our institute.
ABSTRACT
Aim: To describe the clinical management of three teeth with aberrant root canal morphology: a mandibular canine with two radicular canals, maxillary second premolar with three roots and root canals; and maxillary second molar with four roots and root canals, all of which are rare clinical occurrence in our environment. Presentation of Case: This case report summarizes 3 cases with rare root canal morphology treated by non surgical endodontic treatment in which a maxillary first premolar, maxillary second molar and mandibular canine with aberrent root canal morphology. Discussion: It is generally accepted that a major cause for the failure of root canal therapy is an inability to recognize the presence of and to adequately treat all of the canals. The clinical impact of untreated canal spaces may vary from clinical and radio graphical normalcy to severe symptoms of acute pulpitis or apical abscess. Consistent high levels of success in endodontic treatment require an understanding of root canal anatomy and morphology. To achieve endodontic success, the entire root canal system must be derided, disinfected and obturated. The clinician must have a thorough understanding of normal anatomy, and of common variations from the norm. Thus meticulous knowledge of tooth morphology, careful interpretation of angled radiographs, proper access cavity preparation and a detailed exploration of the interior of the tooth is needed to ensure a proper endodontic treatment. Conclusion: The variability of symptoms diagnostic and therapeutic difficulties make the treatment of missed anatomy a challenge for the general dentist; consequently, treatment of these difficult cases should be managed by dentists with advanced training in endodontics.