ABSTRACT
Aim and objectives: To show the incidence of triple negative breast carcinomas in the younger age group (20-40 years) in the study sample and to establish a correlation between expression patterns of estrogen receptor (ER), progesterone receptor (PR) and HER2 /neu with tumour histopathology of breast carcinoma. Material and methods: A 5 years study, 2 years restopective and 3 years prospective was conducted in Mahatama Gandhi Memorial hospital, Warangal, from 2009 to 2014 on triple negative breast carcinomas. All the mastectomy specimens, received in the pathology Department during this period were considered. Results: Total of 28 cases of carcinoma breast in females diagnosed histopathologically, were included in the study. In the present study, the patients were in the age group of 20-40 years Since most carcinomaS in this age group are triple negative. most of the tumours werte of size > 5 cm, 12 cases (43%), followed by 10 cases (36%) of size 2-5 cm. Total 20 (71.4%) were IDC (NOS), followed by 4 (14.2%) were Medullary carcinomas and 2 (7.1%) cases of ILC and each 1 (3.6%) case of tubular and Mucinous carcinomas. Histopathological grading was done according to Modified Bloom Richardson grading and found that 11 (39.3%) were of grade II followed by 5 (17.9%) cases were grede lll,4 cases were of grade I and 8 cases were inassessible. ER and PR were positive in 61% and 47% of tumors respectively. HER-2 over expression was seen in 36% of tumors and was negative in 64% of tumours. Triple negative carcinomas were 4 out of 28 cases, of which 3 were IDC (NOS) and 1 was medullary carcinoma. Triple negative carcinomas are associated with poor prognosis. Conclusion: ER, PR and HER-2 status correlates well with histopathological grading and other clinico-pathological parameters. Higher grade is associated with HER-2 positivity and ER/PR negativity,larger tumor size, lympho-vascular invasion, lymph node metastasis, and higher clinical stage.
ABSTRACT
OBJECTIVE: To compare the frequency and immunohistochemical profiles of triple-negative breast carcinomas in younger and older women. METHODS AND RESULTS: We selected patients diagnosed with triple-negative breast carcinomas. The groups examined were women who were 35 years old or younger between 1997 and 2007 (n = 74) and, for comparison, women who were 60 years old or older (n = 19, consecutive cases). All formalin-fixed and paraffin-embedded tumor samples were reviewed and immunohistochemically stained for ER, PR, HER2, Ki-67 antigen, epidermal growth factor receptor, cytokeratin 5/6, p53, vimentin, CD117, and p63 using tissue microarrays blocks. Triple-negative breast carcinomas corresponded to 34.6 percent (74/213) of the carcinomas from the younger patients and 16.2 percent (19/117) of the carcinomas from the older patients (p = 0.002). No significant differences in the frequency of the basal phenotype were observed in the two patient groups based on CK5/6 and/or epidermal growth factor receptor expression (74.3 percent vs. 68.4 percent). However, triple-negative breast carcinomas in the older patients presented a higher frequency of CK5/6 expression compared to those of younger patients (42.1 percent vs. 9.6 percent; p = 0.005), whereas triplenegative breast carcinomas of younger patients had a higher expression level of epidermal growth factor receptor (71.6 percent vs. 47.3 percent). CONCLUSIONS: These results show that there were significant molecular differences between the triple-negative basal-like breast carcinomas that were diagnosed in younger women and those that were diagnosed in older women. These findings may provide a basis for describing the more aggressive phenotype of the triple-negative breast carcinomas observed in younger women.