ABSTRACT
Background: Breast cancer is a heterogeneous disease that encompasses several distinct entities with remarkably different characteristics . Histological type is the most important aspect of breast carcinoma characteristics. Histological type is associated with differences in epidemiology , diagnostic issues , clinical course & prognosis . Histological special types account for about 25% of breast cancer. Aim-The aim of this study is to identify the incidence and morphology of special types of breast cancers prevalent in our locality along with assessment of IHC status(ER,PR,Her2/neu)for better understanding of rare malignant tumors. Methods: This was aretrospective analysis of all special subtypes of breast cancers over a period of six years (July 2011-June 2017) in the department of Pathology ,VSSIMSAR,Burla,Odisha.Clinicopathological parameters and IHC status were reviewed in all cases. Results: All patients were females with median age of 51 years and undergone modified radical mastectomy. Out of total 448 cases of all breast carcinomas22 cases are of special histologic types.Medullary carcinoma was the most common type ( 7cases )( 13.8%) followed by metaplastic carcinoma(5cases)(22.7%), lobular carcinoma 3(cases )(13.6%),apocrine carcinoma 3(13.6%)cases, papillary carcinoma2(9%)cases, one(4.5%)case each of mucinous carcinoma and sebaceous carcinoma. Conclusion: The identification of the special types has a significant utility in luminal breast cancers and should be considered in therapeutic algorithm.
ABSTRACT
Background: Breast cancer is the second most common cancer in the world and,by far,the most frequent cancer among women with an estimated 1.67 million new cancer cases diagnosed in 2012. It is well established that there are at least 4 main molecular subtypes of breast cancer based on different patterns of gene expression, and they have a considerable impact on outcome. Objective of this study is to establish a comparative analysis of breast cancer by IHC assay in western Odisha and to correlate with reference to tumor sizes, histological grade and lymph node involvement. Methods: This study was conducted in VIMSAR, Burla, Odisha from July 2014 to August 2017 where 66 Cases of radical mastectomy received for routine histopathological evaluation from Dept of Surgery for histological typing and evaluation of IHC status by Dako EnvisionTM FLEX/HRP detection reagent. ER, PR, Her2neu and Ki67 were evaluated as per ASCO/CAP guidelines. The molecular subtypes were correlated with known prognostic markers as tumor size,histologic grade and lymph node status. Results: Triple negative and Her2neu 20.9% of cases were more aggressive and correlated with increased tumor size,higher grade and majority showed lymph node involvement at an early stage. Conclusion: After overall assessment it was seen that majority of cases were Luminal A type followed by triple negative and Her2neu positive cases indicating not only the latter are related to poor outcome but also showed its increased prevalence in this part of odisha possibly because of late presentation. Molecular typing help categorize and plan targeted therapy to patients.