Age related association of her-2/neu with prognostic markers in female breast carcinoma

ABSTRACT

To determine age-related association of Her-2/neu expression with histological and immunohistochemical prognostic markers in female breast carcinoma. Cross sectional, observational study. Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from January 2004 to December 2007. Patients of primary operable female breast carcinoma were categorised as <40 years [pre-menopausal], 41-50 years [pen-menopausal] and > 50 years [post-menopausal] age groups. Histological type, tumour size, tumour grade and lymph node status were determined while estrogen receptor [ER], progesterone receptor [PR] and Her-2/neu expression were evaluated immunohistochemically. Association of Her-2fneu with histological and immnuohistochemical prognostic markers was determined in pre-menopausal, pen-menopausal and post- menopausal age groups using the x[2] test for uni- and multivariate analysis. Out of the 722 patients, 230 [31.9%] were in pre-menopuasal, 221 [30.6%] in pen-menopausal and 271 [37.5%] in post-menopausal age group. Infiltrating ductal carcinoma was the pre-dominant subtype in all the age groups. Mean tumour size was 4.3 +/- 2.3 cm [range 0.4-17 cm] and lymph node metastasis was seen in 310 [70.8%] cases. Her-2/neu showed association with ER in the all the age groups while PR only showed association in the pen-menopausal and postmenopausal women. Her-2/neu showed no association with tumour size, tumor grade and lymph node metastases in pre-menopausal and pen-menopausal women while it showed positive association with tumour size and lymph node metastasis in the post-menopausal women [p <0.05]. Majority [62%] patients were under 50 years as against the Western epidemiology. Association of Her-2/neu with ER, PR, tumour size and lymph node metastasis was age related as pre-menopausal, pen-menopausal and post-menopausal had variable expression of these prognostic markers with therapeutic and prognostic implications