Expression of ER, PR and HER 2 Receptor Status in Breast Carcinomas and its Correlation with Histopathological Grading

ABSTRACT

Introduction: Breast cancer is the most common cancer in women in developed countries. In India; it is second to cancer of cervix among women. Several histopathological features have prognostic significance in breast carcinoma which includes histologic subtype, grade, lymph node status, ER/PR status, Growth factors and its receptors, proliferation activity and DNA content, oncogenes and tumor suppressor genes. The Immunohistochemistry (IHC) classification provides both therapeutic and prognostic information. Aim and objectives: To assesses the ER/PR status and HER -2 status of breast carcinoma, to correlate the ER/PR and HER-2 receptors status with modified Bloom- Richardson histological grading, and clinico pathological parameters. Materials and methods: This study was undertaken over a period of 2 years from August 2013 to July 2015 in the Department of Pathology, Chalmeda Anand Rao Institute of Medical Sciences. Total of 75 cases of carcinoma breast in females diagnosed histopathologically, belonging to age group of 21-85 years were included in the study. Pingle Prathyusha, Radhika Mucharla, V. Srinivas Kumar, Geeta Voolapalli, Thota Ravinder. Expression of ER, PR and HER 2 Receptor Status in Breast Carcinomas and its Correlation with Histopathological Grading. IAIM, 2019; 6(7) 49-58. Page 50 Results: Histopathological grading was done according to Modified Bloom Richardson’s grading. 27(36%) cases were of grade II and 24(32%) cases each were of grade I and grade III. ER and PR were positive in 76% and 58.7% of tumors respectively. HER-2 over expression (score 2+ & 3+) was seen in 44% of tumors and was negative (0 or 1+) in 56% of tumors. Among the most common histologic subtype i.e., IDC (NOS), ER, PR and HER-2 were expressed in 75.36%, 60.86% and 44.92% respectively. Tumors with ER/PR-, HER2+ subtype were larger (>5cms), 1(1.3%) each medullary and apocrine carcinoma were positive for HER-2. None of the lobular, mucinous and papillary carcinoma expressed HER-2. Statistically significant values were noted for histologic grade immunohistochemical sub types, lympho vascular invasion and nuclear pleomorphism. Conclusion: In this study ER, PR and HER-2 receptors status correlates well with histopathological grading and other clinico-pathological parameters. These assays have the advantage of allowing only tumor cells to be assessed for receptor status. They can be conducted relatively inexpensively on routinely processed tissue sections with no need for specialized equipment.