The Predictive and Prognostic behavior of Breast Cancer by NACT in Relation to Tumor Grade, ER/PR and Her- 2/neu Expression- Study in a Tertiary Care Hospital of Eastern India

ABSTRACT

Introduction: Neo-adjuvant chemotherapy (NACT) isconsidered as initial management of all patients with locallyadvanced breast cancers and followed by surgery. NACTenables reduction of breast tumor size- thereby prolongingsurvival and altered the expression of steroid receptor (ER/PR)and Her-2/NEU in the cancer cells. Our aims and objectivewas to look into the association of patient age, tumor grade,expression status of ER/ PR / Her-2/neu receptor status beforeand after NACT in Indian women patients.Material and methods: The study was conducted over aperiod of 4 years. Hormone receptor and Her-2/neu status wasdetermined by IHC over 412 samples. The patients receivingNACT and having both core needle biopsy and surgery(MRM) are considered as NACT group. The other group didnot receive NACT but have core needle biopsy and surgeryare taken as non NACT group. The discordance was comparedbetween these two groups.Results: Patients of more than 40years of age hadpredominantly favorable hormone receptor status expression.In the NACT group favorable receptor status was 60.35%and discordance was higher in ER, PR and HER- 2/neu incomparison to non-NACT group.Conclusions: Significant alteration of hormone receptorsand Her-2/neu expression was found in biopsy of the patientsreceiving NACT. So reevaluation of the hormonal status andHer 2 neu receptor in residual invasive carcinoma may beconsidered as it has advantage on chemotherapy after finalsurgery.