Correlation between estrogen receptor, progesterone receptor, HER-2/neu status and other prognostic factors in carcinoma breast in Indian population
DOI:
https://doi.org/10.18203/2349-2902.isj20151000Keywords:
Breast carcinoma, ER, PR, HER-2/neu, Breast prognostic factorsAbstract
Background:Incidence of breast carcinoma (BC) is increasing all over the world. Contrary to the West where it is more common in the elderly; in India it is more common among the younger women. India accounts for nearly six percent of deaths, due to breast cancers in the world and also that one out of every 22 women in India is diagnosed with breast cancer every year. But no information is available on its biological characteristics in the Indian population. Our aim was to evaluate the estrogen receptor, progesterone receptor and HER-2/neu receptor in single institute patients and to compare the expression of these factors with other prognostic parameters such as menopausal state, size of tumor, grade, histological type, mitotic index, lymphovascular invasion and nodal metastases.
Methods: This is a prospective study conducted in the Department of General Surgery at Sri Ramachandra Medical University Hospital, Chennai, India. A batch of 60 confirmed patients of BC, diagnosed in between 2012 to 2014, were included in this study. ER, PR and HER-2/neu status were studied by immune-histochemistry and were correlated with other prognostic factors.
Results:ER negative and PR negative cases were comparatively high (61.7% and 70%) than the positive cases. 66.7% of the cases were post-menopausal group, 68.3% of cases were T2 tumor and 81.7% cases were ductal carcinoma. There was a significant correlation identified between ER, PR with tumor grade and Mitotic Index of the tumor. HER-2/neu positive cases tended to have significant higher axillary metastasis. There was no significant correlation between ER, PR and HER-2/neu with menopausal state, size, histological type and lymphovascular invasion.
Conclusions:The ER, PR and Her2/neu expression in BC in our patients is comparable with the available international data. ER and PR negative expressions are strongly associated with some known bad pathological factors like high grade tumor and high Mitotic Index. HER-2/neu expression was high in advanced diseases like axillary node positive patients.
References
Birrell SN, Hall RE, Tilley WD. Role of the androgen receptor in human breast cancer. 1998;3:95-103.
Nandkumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. GeoFigureic pathology revisited: Development of an atlas of cancer in India. Int J Cancer. 2005;116:740-54.
Payne SJ, Bowen RL, Jones JL, Wells CA. Predictive markers in Breast Cancer the Present Histopathology. 2008;52:82-90.
Chauhan A, Subba SH, Menezes RG, Shetty BS, Thakur V, Chabra S. Younger women are affected by breast cancer in South India – a hospital based study, Asian Pac J Cancer Prev. 2011;12(3):709-11.
Fisher B, Bauer M, Wickerham DL. Relation of number of positive auxiliary nodes to the prognosis of patients with primary breast cancer. An NSABP update. Cancer. 1983;52(9):1551-7.
Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer. 1989;63(1):181-7.
Eiston CW, Ellis IO. Pathological prognostic factors in breast cancer. The value of histological grade in breast cancer: Experience from a large study with long term follow-up. Histopathology. 1991;19(5):403-10.
Han W, Kim SW, Park IA. Young age: an independent risk factor for disease-free survival in women with operable breast cancer. BMC Cancer. 2004;4:82.
Kroman N, Jensen M, Wohlfahrt J, Mouridsen HT, Andersen PK, Melbye M. Factor influencing the effect of age on prognosis in breast cancer: population based study. BMJ. 2000;320.
Kim YS, Konoplev SN, Montemurro F, Smith TL, Rondon G, Ghamplin RE, et al. HER-2/neu over expression as a poor prognostic factor for patients with metastatic breast cancer undergoing high-dose Chemo therapy with autologous stem cell transplantation. Clin cancer Res. 2001;7(12):4008-12.
Weidner N, Sample JP, Welch WR. Tumor angiogenesis and metastasis–correlation in invasive breast carcinoma. N Engl J Med. 1991;324:1-8.
Hefti MM, Hu R, Knoblauch NW, Collins LC, Haibe-Kains B, Tamimi RM, et al. Estrogen receptor negative/progesterone receptor positive breast cancer is not a reproducible subtype. Breast cancer Res. 2013;15(4):R68.
Onitilo AA, Engel JM, Greenlee RT, Mukesh BN. Breast Cancer Subtypes Based on ER/PR and Her2 Expression: Comparison of Clinicopathologic Features and Survival. clin med res. 2009;7(1-2):4-13.
Tewari M, Krishnamurthy A, Shukla HS. Predictive markers of response to neoadjuvant chemotherapy in breast cancer. Surg Oncol. 2008;17(4):301.
Breasted J H: The Edwin Smith Surgical Papyrus. Chicago: University of Chicago Press, 1930, p 405. Classics of Medicine Library, vol. III.
Celsus AC. De Medicina, Vol II. Eoeb Classical Eibrary Ed, Book V. Cambridge: Harvard University Press 1935;131.
Beenken. History of the therapy of breast cancer, in Bland and Copeland. The Breast: Comprehensive Management of Benign and Malignant Disorders. Philadelphia: Saunders. 2004:5.
Moore C. On the influence of inadequate operations on the theory of cancer. R Med Chir Soc. 1867;1:244.
Halsted WS. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June 1889, to January 1894. Ann Surg. 1894;20:497.
Burstein HJ, Hams JR, Marrow M. Malignant Tumors of the Breast. Devita 8th edition. 2008;43(2):1606-12.
Winer EP, Hudis C, Burstein HJ. American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report. J Clin Onc. 2005;23(3):619-29.
Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet. 1998;351(9114):1451-67.
Wolff AC, Hammond MEH, Schwartz JN. American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer. Arch Pathol Lab Med. 2007;131(1):18-43.
Bland IK, Beenken WS, Copeland EM. The Breast Schwartz Text Principles of Surgery 9th edition. 2008;15:453-94.
Love RR, Duc NB, Dinh NV, Quy TT, Xin Y, Havighurst TC. Young age as an adverse prognostic factor in premenopausal women with operable breast cancer. Clinical Breast Cancer. 2002;2:294-8.
Azizun-Nisa1, Bhurgri Y, Raza F, Kayani N. Asian 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. Pac J Can Prev. 2008;9(4):553-6.
Bouchbika Z, Benchakroun N, Taleb A, Jouhadi H, Tawfiq N, Sahraoui S. Association between Overexpression of Her-2 and Other Clinicopathologic Prognostic Factors in Breast Cancer in Morocco.Journal of Cancer Therapy. 2012;3:787-92.
Ayadi L, Khabir A, Amouri H, Karray S, Dammak A, Guermazi M. Correlation of HER-2 Over-Expression with Clinico-Pathological Parameters in Tunisian Breast Carcinoma. World Journal of Surgical Oncology. 2008;6:112.
Faheem M1, Mahmood H, Khurram M, Qasim U, Irfan J. Estrogen receptor, progesterone receptor, and Her 2 Neu positivity and its association with tumor characteristics and menopausal status in a breast cancer cohort from northern Pakistan. Ecancermedicalsciene. 2012;6:283.
Hussein MR, Abdul Wahed SR, Abdul Wahed AR. Alterations of estrogen receptors, progesterone receptors and c-erbB2 oncogene protein expression in ductal carcinomas of the breast. Cell Bio lint. 2008;32(6):698-707.
Bhatavdekar JM, Patel DD, Shah NG, Vora HH, Suthar TP, Chikhlikar PR. Prognostic Significance of Immunohistochemically Localized Biomarkers in Stage II and Stage III Breast Cancer: A Multivariate Analysis. Annals of Surgical Oncology. 2004;7(4):305-11.
Ivkovic-Kapicl T, Knezevic-Usaj S, Djilas-Ivanovic D, Panjkovic M. Correlation of Her-2/neu Protein Over- expression with Other Prognostic and Predictive Factors in Invasive Ductal Breast Cancer. Anticancer Research. 2007;21(4):673.
Barrios GRM. HER2/neu incidence in early breast cancer and its correlation with others prognostic factors , Journal of Clinical Oncology. 2008;26.
Fatima S1, Faridi N, Gill S. Breast cancer: steroid receptors and other prognostic indicators. J Coll Physicians Surg Pak. 2005;15(4):230-3.
Almasri MN, Hamad M. Immunohistochemical evaluation of human epidermal growth factor receptor 2 and estrogen and progesterone receptors in breast carcinoma in Jordan Breast Cancer Research. 2005;7:598-604.
Mostafa MG, Larsen MT, Love RR. Estrogen Receptor, Progesterone Receptor, and Her-2/neu Oncogene Expression in Breast Cancers among Bangladeshi Women. Bangladesh Coll Phys Surg. Author manuscript; available in PMC, 2012.
Naqvi SQH, Jamal Q, Mahmood RK, Zaidi SMH, Abbas F. Significance of her 2 neu oncoprotein over expression on node positive invasive breast cancer. J coll Physician Surg, 2002.
Mohammed ZM. The relationship between lymphovascular invasion and angiogenesis, hormone receptors, cell proliferation and survival in patients with primary operable invasive ductal breast cancer. BMC Clinical Pathology. 2013;13:31.
