Axillary lymph node status in primary breast carcinoma; association of axillary lymph node status with ER/PR, HER2/NEU and MMP-I in primary breast carcinoma

ABSTRACT

The most important prognostic factor in patients of breast carcinoma is axillary lymph node metastasis. Current study was conducted to find the frequency of lymph node metastasis in hundred cases of primary breast carcinoma and association of lymph node status with immunohistochemical expression of ER/PR,HER2/neu and MMP-1[matrix metalloproteinase-1]. Descriptive study. Aug 2012 to Jun 2013. U.H.S laboratory of Morbid Anatomy and Histopathology Lahore. One hundred mastectomy specimens with axillary lymph node dissection were included. After gross examination, tissue processing and microtomy the tissue slices of 4 micrometer were taken on frosted and lysine coated slides. H/E and IHC for ER/PR,HER2/neu and MMP-1 were done according to protocol. Among 100 breast cancer subjects, 72 were positive for lymph node metastasis while 28 subjects were negative. A significant association between lymph node status and ER IHC expression was noticed. When Chi square test was applied with p-value of 0.001 was observed.Also a significant association between lymph node status and PR IHC expression was noticed. Chi square test was applied and the p-value of 0.004 was obtained.Association between lymph node status and HER2/neu IHC expression was analysed. Chi square test was applied with a p-value of 0.467 was obtained [not significant].A significant association between lymph node status and MMP-1 IHC expression was observed. Chi square test was applied anda p-value of 0.004 was obtained. Most of the primary breast carcinomas were presented with axillary lymph node metastasis [72%].Significant associations were observed between lymph node status and ER/PR immuonohistochemical expressions however the association between HER2/neu IHC and lymph node status was not statistically significant. The immunohistochemical expression of MMP-1 is significantly associated with lymph node status. It shows that it is an important marker for metastatic potential in breast carcinoma