Estrogen and Progesterone Receptors in Breast Malignancy-Their Expression and Correlation with Histologic Parameters in Southern India

Breast carcinoma is the most common malignancy among South Indian women. Hormone receptor evaluation has become crucial for management of breast cancer. Very few studies have correlated oestrogen receptors (ERs) and progesterone receptors (PRs) with histologic parameters in Andhra Pradesh state of Southern India; therefore, the study was undertaken, and it is also to study the importance of immunohistochemistry (IHC) evaluation of ER and PR status and to evaluate and conclude the importance of modified Bloom-Richardson (MBR) grading in a routine investigation for prognosis and prediction of clinical outcomes. Aims and Objective (1) To evaluate the expression of hormone receptors in breast carcinoma and (2) to correlate their expression with other histological variables. Materials and Methods A prospective study was conducted for 2 years, at a tertiary care hospital in Vijayawada, Andhra Pradesh, India. In our study, 100 consecutive cases were included, which were reported by MBR system and evaluated for ER & PR receptor expression by Allred score. Statistical analysis was done by SPSS software, Student t-test and chi-square test. Results Majority of the age group affected was below 50 years, and mean age of the study population was 46.25 years. The most common histological variant was infiltrating duct cell carcinoma (91%), and predominant histological grade was MBR grade II (47%). ER and PR positivity were noted in 56% and 53% of cases, respectively. The common phenotypic expressions were ER+ PR+ (46%) & ER-PR-(37%). ER positivity was observed in 25% of grade I, 54.54% of grade II and 20.46% of grade III lesions (p = 0.005), and expression of PR was seen in 25.53% of grade I, 51.06% of grade II and 23.54% of grade III lesions (p = 0.001). ER+ PR+ phenotypic expression was positively correlated with low histologic grade, whereas ER-PR-correlated with high histological grade (p = 0.003). ER+ PR+ also correlated with lymphatic spread (p = 0.046) and vascular invasion (p = 0.011). However, no correlation was observed with age, tumour size and ER & PR expression (p > 0.05). Conclusion High nuclear pleomorphism, low tubule formation, high mitotic score & lymphovascular invasion were found more common in ER-PR-group than in ER+ & PR+ group with significant statistical correlation. ER & PR expression showed statistically significant correlation with MBR system and other pathological parameters. Hence, MBR grading should be incorporated as a routine investigation for prognosis and prediction of clinical ou Breast carcinoma (CA), Oestrogen receptor (ER), Immunohistochemistry (IHC), Invasive ductal carcinoma (IDC), Modified Bloom-Richardson grading (MBR), Progesterone receptor (PR) nuclear pleomorphism.