Morphological profile and association of HER-2/Neu with prognostic markers in breast carcinoma in northern Pakistan

ABSTRACT

To determine the morphological profile and association of HER-2/neu expression with histological prognostic markers and hormonal receptor expression in female breast carcinoma in Northern Pakistan. Cross-sectional, observational study. Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from January 2004 to May 2007. A total of 535 patients of primary operable female breast carcinoma with hormonal profile and biological status were included in the study. Patient`s age, microscopic tumour size, tumour grade, lymph node status, Estrogen Receptor [ER], Progesterone Receptor [PR] and joint ER/PR status were evaluated and their association was determined with HER-2/neu expression using the x2 test for univariate analysis. Out of 535 cases, there were 481 [89.9%] cases of infiltrating ductal carcinoma with mean age of 48 years and mean tumour size of 4.4 cm. Tumour grade II was seen in 68% cases and lymph node metastases were present in 65% cases. HER-2/neu expression was seen in 31% cases, while ER and PR expression was seen in 72.3% and 62.6% respectively. ER and PR showed inverse association with HER-2/neu while positive association was seen with lymph node metastases [p < 0.05]. No association was seen between tumour size and tumour grade. Joint ER and PR expression also showed a higher number [73.5%] of HER-2/neu negative cases. HER-2/neu, ER and PR expression is comparable to the West with inverse association with ER and PR and positive association with lymph node metastases. Since HER-2/neu expression is variable in carcinomas with different tumour characteristics, it is not possible to predict hormone receptor expression in all the cases