Evaluation of estrogen receptors in relation to activity of breast duct carcinoma

ABSTRACT

Breast cancer is the most common cause of death in middle aged women and affect a million women worldwide each year. The breast is the target organ for estrogen. This hormone controls several functions of the normal and abnormal mammary epithelium inducing cell proliferation. Most of the actions of estrogen are mediated via specific steroid receptors, and proliferate cells should contain estrogen receptors [ERs]. Several tumor markers have been mentioned for breast cancer like carcinoembryonic antigen [CEA], and cancer antigen [CAI5-3]. This study included 23 individuals participated in the study and were divided into 2 groups, group [1] [benign group which was considered the control group and group [2] [malignant group] which was subdivided into 3 groups according to the pathological grading. The expression of estrogen receptors [ER] was immunohistochemically investigated in 18 formaline-fixed paraffin embedded invasive breast carcinoma. 9 cases of 18 [50%] showed a positive nuclear immunoreactivity with both MoAbs against ER. In this study we found a distinct extremely significant and direct proportional relationship [p <0.01] between the histological grades [I, II, III] and ER nuclear immunoreavtivity. The majority of grade [III] tumors 4/5 [80%], were [ER] positive. In contrary grade [I] tumors and grade [II], 5/13 [3 8%] had low number of[ER] positive than the high grade [grade III]. In this study, the ER positive nuclear staining pattern was classified according to their intensity. The intensity of ER in different grades was, in grade [I] the weak intensity [+] was 1/1 [100%] while the moderate intensity [++] and strong [+++] were 0%. In grade [II], the weak intensity [+] was 1/4 [25%], the moderate was 3/4 [75%] and the strong was 0%. In grade [III], the weak intensity [+] was 0% while the moderate was [25%] and the strong record the maximum level 3/4 [75%.] The level of estrogen hormone in breast cancer patients as well as in control women. The mean level of estrogen hormone in cancer breast patients was extremely significant elevated than that in corresponding control [p=<0.0001[. The mean level of estrogen hormone was directly proportional with the histopathological grades. Serum CAI5.3was significantly increase than that in corresponding control. There was a direct proportional correlation between tumor grade and serum level of CAl 5.3 as a tumor marker for cancer breast. By comparison between different groups of patients with cancer breast we found that serum level of CAl 5.3 was significantly increased in grade II than grade I [p>0.05] and this correlation was extremely significant between grade III and both grade I and Grade II [p<0.01]. CEA was increased in cancer breast patient than that in corresponding control, this increase not reach the significance level in patients with grade I and grade II while in grade III this increase reach the significance level [p>0.01]. Among the different groups there was no any significant correlation between them in CEA level