The Predictive and Prognostic behavior of Breast Cancer by NACT in Relation to Tumor Grade, ER/PR and Her- 2/neu Expression- Study in a Tertiary Care Hospital of Eastern India

Introduction: Neo-adjuvant chemotherapy (NACT) isconsidered as initial management of all patients with locallyadvanced breast cancers and followed by surgery. NACTenables reduction of breast tumor size- thereby prolongingsurvival and altered the expression of steroid receptor (ER/PR)and Her-2/NEU in the cancer cells. Our aims and objectivewas to look into the association of patient age, tumor grade,expression status of ER/ PR / Her-2/neu receptor status beforeand after NACT in Indian women patients.Material and methods: The study was conducted over aperiod of 4 years. Hormone receptor and Her-2/neu status wasdetermined by IHC over 412 samples. The patients receivingNACT and having both core needle biopsy and surgery(MRM) are considered as NACT group. The other group didnot receive NACT but have core needle biopsy and surgeryare taken as non NACT group. The discordance was comparedbetween these two groups.Results: Patients of more than 40years of age hadpredominantly favorable hormone receptor status expression.In the NACT group favorable receptor status was 60.35%and discordance was higher in ER, PR and HER- 2/neu incomparison to non-NACT group.Conclusions: Significant alteration of hormone receptorsand Her-2/neu expression was found in biopsy of the patientsreceiving NACT. So reevaluation of the hormonal status andHer 2 neu receptor in residual invasive carcinoma may beconsidered as it has advantage on chemotherapy after finalsurgery.

HER-2/neu expression in lesions of uterine cervix: Is it reliable and consistent.

This study was conducted to evaluate the expression of HER-2/neu oncogene in the lesions of the uterine cervix and to determine its correlation with histological type of malignancy, grade and clinical stage of presentation. One hundred cervical specimens were included in this study. These comprised cases with diagnosis of benign epithelial lesions, squamous cell carcinoma, adenocarcinoma, carcinoma cervix with glandular differentiation and cervical intraepithelial neoplasia. HER-2/neu immunostaining was performed by streptovidin-biotin peroxidase method. Higher expression of HER-2/neu was noted in malignant lesions as compared to benign lesions. Intensity of staining also correlated with clinical stage of presentation, lymph node metastasis and presence of parametrial extension. The over-expression of HER-2 oncoprotein is associated with poor prognosis, metastatic potential and aggressive biological behavior.