Published: 2019-08-28

Incidence of triple negative breast cancer at Rajendra Institute of Medical Sciences, Ranchi

Priyanka Kumari, Sumit Bhaskar, Rajiv Ranjan, Dipendra Kumar Sinha


Background: Breast carcinoma is the second most common carcinoma in women and accounts for 22% of all female cancer, which is more than twice the prevalence of cancer in women at any other site. Triple negative breast cancer, i.e., negative expression of oestrogen and progesterone receptors and HER2/neu receptors and accounts for approximately 10-17% of all breast carcinomas, is biologically aggressive, resistant to conventional cytotoxic chemotherapy treatment, and is associated with reduced survival compared to other subtypes of breast cancer.

Methods: History, local examination, Various investigations like: FNAC of breast lump and axillary lymph node, USG of breasts and axilla, USG of whole abdomen and pelvis, Chest X-ray PA View etc, ER/PR and HER-2/neu status on the specimen sent for HPE were done. The prognostic implications on ER, PR and HER-2/neu receptors were assessed indirectly with the help of Nottingham prognostic index (NPI)).

Results: A statistically significant correlation of ER/PR receptor status was found with tumour size, no. of lymph nodes, tumour grade and NPI, whereas HER2/neu receptor status had a statistically significant correlation with tumour size and no. of lymph node involved. Incidence of triple negative breast cancer in this Institute is 20%.

Conclusions: ER, PR and HER2/neu receptor status is highly important predictor in cases of carcinoma breast which necessitates routine evaluation of these receptor statuses for better management of disease.


ER, PR and HER2/neu receptors, FNAC, USG, Triple negative breast cancer

Full Text:



Birrell SN, Hall RE, Tilley WD. Role of the androgen receptor in human breast cancer. 1998;3:95-103.

Brunicardi FC, Brandt ML, Andersen DK, Billiar TR, David LD, Hunter JG, et al. Schwartz’s principles of surgery. 2009;9:436-54.

Jemal A, Cancer statistics 2008; CA Cancer J Clin. 2008;58:71.

Almasri NM, Mohammad AH. Immuno-histochemical evaluation of human epidermal growth factor 2 and oestrogen and progesterone receptors in breast carcinoma in Jordan. Breast Cancer Res. 2005;7(5):R598-604.

Anita K. Breast Cancer in India: Where Do We Stand and Where Do We Go? Asian Pacific J Cancer Prev. 2012;13;4861-6.

Tewari M, Krishnamurthy A, Shukla HS. Predictive markers of response to neoadjuvant chemotherapy in breast cancer. Surg Oncol. 2008;7:301-11.

Anonymous. Breast cancer in developing countries. Lancet. 2009;374:1567.

Guidelines for management of breast cancer/by WHO Regional Office for the eastern Mediterranean: EMRO Technical Publications Series; 31.

Breast RJ. Rosai and Ackerman’s Surgical Pathology. 9th edition. Missouri: Elsevier; 2004: 1763-1827.

Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF. Hormone receptor status of breast cancer in India: a study of 798 tumors. Breast. 2000;9:267-70.

Mamoon N, Hassan U, Mushtaq S. Breast carcinoma in young women aged 30 or less in Northern Pakistan- the Armed Forces Institute of pathology experience. Asian Pac J Cancer. 2009;10:1079-82.

Hall IJ, Moorman PG. Millikan RC, Newman B. Comparative analysis of breast cancer risk factors among African American women and white women. AmJ Epidemol. 2005;161:40-51.

Jatoi I, Anderson WF, Rao SR, Devesa SS. Breast cancer trends among black and white women in the United States. J Clin Oncol. 2005;23:7836-41.

Sainbury R. The breast: Short Practice of Surgery bailey and love. 26th edition. 2012: 810.

Taylor CR, Shi SR, Barr NJ, Wu N. Techniques immune histochemistry. Principles, pitfalls and standardization. In: Dabbs D (ed). Diagnostic immunohistochemistry. 2nd edition. Churchill Livingston: Elsevier; 2006.

National Institute of Health Consensus Development Panel Conference statement; Adjuvant therapy for breast cancer, November 1-3, 2000. J Natl Cancer InstMonogr. 2010;5-15.

Fisher ER, Anderson S, Tan-Chiu E, Fisher B, Eaton L, Wolmark N. Fifteen- year prognostic discriminants for invasive breast carcinoma: National Surgical Adjuvant Breast and Bowel Project Protocol-06. Cancer. 2001;91(8 Suppl):1679-87.

Ruder AM, Lubin F, Wax Y, Geier A, Alfundary E, Chetrit A. Estrogen and progesterone receptor in breast cancer patients. Epidemiologic characteristics and survival differences. Cancer. 1989;64(1):196-202.

Al-Moundhri M, Nirmala V, Al-Mawaly K. Significance of p53, Bcl-2 Saleh F, Abdeen S. Pathobiological features of breast tumours in the State of Kuwait: a comprehensive analysis. Journal of Carcinogenesis. 2007;6:12. and HER2/neu protein expression in omani arab females with breast cancer. Pathology Oncology 2003; 9(4):226-31.

Saleh F, Abdeen S. Pathobiological features of breast tumours in the State of Kuwait: a comprehensive analysis. J Carcinogenesis. 2007;6:12.

Ambroise M, Ghosh M, Mallikarjuna VS. Immunohistochemical profile of breast cancer patients at a tertiary care hospital in south India. Asian Pacific J Cancer Prev. 2011;12(3):625-9.

Huang HJ, Neven P, Drijkoningen M. Association between tumour characteristics and Her2/neu by immunohistochemistry in 1362 women with primary operable breast cancer. J Clin Pathol. 2005;58(6):611-6.

Rashed MM, Ragab NM, Galal MK. The association of Her2/neu over-expression in relation to p53 nuclear accumulation, hormonal receptor status and common clinico-pathological prognostic parameters in a series of Egyptian women with invasive ductal carcinoma. Eur J Gen Med. 2007;4(2): 73-9.

Vaidyanathan K, Kumar P, Reddy CO. ErbB-2 expression and its association with other biological parameters of breast cancer among Indian women. Indian J Cancer. 2010;47(1):8-15.

Mohla S, Sampson CC, Khan T, Enterline JP, Leffall L Jr, White JE. Estrogen and progesterone receptors in breast cancer in Black Americans: Correlation of receptor data with tumor differentiation. Cancer. 1982;50(3):552-9.

Eisenberg A, Lucia A, Koifman S. Hormone receptors: association with prognostic factors for breast cancer; Revista Brasileria de Cancerologia. 2001, 47(1):49-58.

Goyanes R, Irene A, Perez Xiomara E, Camacho RR, Orozco LM, Franco OS, et al. Hormone Receptors and Other Prognostic Factor in Breast Cancer in Cuba; Cancerologia 3(2008):19-27. Reprinted in MEDICC Review, Winter. 2010;1:36-40.

Naem M, Nasir A, Aman Z, Ahmad T, Samad T. Frequency of her2/neu receptor positivity and its association with other features of breast cancer. J Ayub Med Coll Abottabad. 2008;20(3).

Dogan RK, Ahmet M, Unal E, Saliha JC, Pervin D, Akan YO. An analysis of HER2/neu gene status in invasive ductal carcinoma using immunohistochemistry and fluorescence in situ hybridisation. Turk J Med Sci. 2011;41(5):809-19.

Stierer M, Rosen H, Weber R, Hanak H, Spona J, Tucheler H. Immunohistochemical and biochemical measurement of estrogen and progesterone receptors in primary breast cancer: correlation of histopathology and prognostic factors. Ann Surg. 1993;218:13-21.

Macgrogan G, Soubeyran I, De Mascarel I. Immunohistochemical detection of progesterone receptors in breast invasive ductal carcinomas: a correlative study of 942 cases. Appl Immunohistichem. 1996;4:219-27.

Gadelkarim AH, Mohammed Ali AA, Abdullah Kasim AT. Correlations of hormone receptors (ER and PR), her2/neu and p53 expression in breast ductal carcinoma among Yemeni women, The Open Cancer Immunology Journal. 2011;4:1-9.

Vaidyanathan K, Kumar P, Reddy CO, Deshmane V, Somasundaram K, Mukherjee G. ErbB-2 expression and its association with other biological parameters of breast cancer among Indian women. Indian J Cancer. 2010;47(1):8-15.

Moradi-Marjaneh M, Homaei-Shandiz F, Shamsian SAA. Correlation of HER2/neu over expression, p53 protein accumulation and steroid receptor status with tumor characteristics: an iranian study of breast cancer patients. Iranian J Publ Health. 2008;37(3):19-28.

Nisa A, Bhurgri Y, Raza F. Comparison of ER, PR and HER/2/neu (C-erb B 2) reactivity pattern with histologic grade, tumor size and lymph node status in breast cancer. Asian J Cancer Prevention. 2008;9(4):553-6.

Kollias J, Murphy CA, Elston CW, Ellis IO, Robertson JF, Blamey RW. The prognosis of small primary breast cancers. Eur J Cancer.1999;35:908-12.

Onitilo AA, Engel JM, Greenlee RT, Mukesh BN. Breast Cancer Subtypes based on ER/PR and HER2 expression: Comparison of clinicipathologic Features and survival. Clinical Medicine & Research, 2009; 7:4-13.

Huang JH, Neven P, Drijkoningen, M. Paridaens, R. Wildiers H, Limbergen VE. Association between tumor characteristics and HER2/neu by immunohistochemistry in 1362 women with primary operable breast cancer. J Clin pathol, 2005;5.