Volume : 6, Issue : 12, December - 2017

Prognostic classification of Breast carcinoma on molecular basis using ER, PR, Her-2/neu and ki67: A study conducted on 56 patients in RIMS, Ranchi, Jharkhand, India

Alok Kumar, Ratna Chaudhary, Arvind Kumar, Abhishek Verma

Abstract :

<p>&nbsp;<b><span style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Objective:</span></b></p> <p class="MsoNormal" style="line-height:150%"><span style="font-size:14.0pt;&#10;line-height:150%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">To &nbsp;classify &nbsp;the &nbsp;cases &nbsp;of &nbsp;east &nbsp;carcinoma &nbsp;coming &nbsp;to &nbsp;RIMS, &nbsp;Ranchi &nbsp;into &nbsp;Luminal &nbsp;A, &nbsp;B, &nbsp;Her-2/neu &nbsp;and &nbsp;basal &nbsp;like &nbsp;using &nbsp;IHC &nbsp;Markers- &nbsp;ER, &nbsp;PR, &nbsp;Her-2/neu &nbsp;and &nbsp;ki67&nbsp; <o:p></o:p></span></p> <p class="MsoNormal"><b><span style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Materials &nbsp;and &nbsp;methods</span></b><span style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: <o:p></o:p></span></p> <p class="MsoNormal" style="line-height:150%"><span style="font-size:14.0pt;&#10;line-height:150%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">In &nbsp;our &nbsp;study &nbsp;on &nbsp;56 &nbsp;patients &nbsp;with &nbsp;east &nbsp;carcinoma, &nbsp;were &nbsp;taken &nbsp;into &nbsp;account &nbsp;and &nbsp;the &nbsp;expression &nbsp;of &nbsp;Hormonal, &nbsp;markers &nbsp;ER, &nbsp;PR, &nbsp;Her-2 &nbsp;and &nbsp;ki67&nbsp; were &nbsp;determined &nbsp;by &nbsp;immune-histo-chemistry &nbsp;and &nbsp;classification &nbsp;into &nbsp;Luminal &nbsp;A, &nbsp;B, &nbsp;Her-2 &nbsp;and &nbsp;Basal &nbsp;like &nbsp;were &nbsp;done <b>&nbsp;</b>subsequently.<b><o:p></o:p></b></span></p> <p class="MsoNormal" style="margin-right:-34.65pt;text-align:justify;line-height:&#10;150%"><span style="font-size:14.0pt;line-height:150%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">&nbsp;</span></p> <p class="MsoNormal" style="margin-right:-34.65pt;text-align:justify;line-height:&#10;150%"><span style="font-size:14.0pt;line-height:150%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">&nbsp;<b>Results:</b> <o:p></o:p></span></p> <p class="MsoNormal" style="margin-right:-34.65pt;text-align:justify;line-height:&#10;150%"><span style="font-size:14.0pt;line-height:150%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">During &nbsp;the &nbsp;study &nbsp;period &nbsp;a &nbsp;total &nbsp;of &nbsp;56 &nbsp;cases &nbsp;of &nbsp;Breast &nbsp;carcinoma &nbsp;were &nbsp;subjected &nbsp;to &nbsp;immune-histo-chemistry. &nbsp;The &nbsp;maximum &nbsp;number &nbsp;of &nbsp;patients &nbsp;was &nbsp;in &nbsp;the &nbsp;age &nbsp;group &nbsp;of &nbsp;51-60 &nbsp;years &nbsp;of &nbsp;age. &nbsp;The &nbsp;study &nbsp;comprised &nbsp;mainly &nbsp;of &nbsp;females &nbsp;with &nbsp;a &nbsp;male &nbsp;to &nbsp;female &nbsp;ratio &nbsp;of &nbsp;1:28. &nbsp;Histologically, &nbsp;51 &nbsp;cases &nbsp;(91.07%) &nbsp;were &nbsp;invasive &nbsp;ductal &nbsp;carcinoma &nbsp;NOS. &nbsp;As &nbsp;per &nbsp;Bloom &nbsp;Richardson &nbsp;grading, &nbsp;23 &nbsp;patients &nbsp;(41.07%) &nbsp;were &nbsp;of &nbsp;Grade &nbsp;I, &nbsp;19 &nbsp;patients &nbsp;(33.92%) &nbsp;of &nbsp;Grade &nbsp;II &nbsp;and &nbsp;14 &nbsp;patients &nbsp;(25%) &nbsp;of &nbsp;Grade &nbsp;III. &nbsp;Out &nbsp;of &nbsp;14 &nbsp;cases &nbsp;of &nbsp;Bloom &nbsp;Richardson &nbsp;Grade &nbsp;III, &nbsp;9 &nbsp;had &nbsp;high &nbsp;ki67 &nbsp;index &nbsp;(64.28%). &nbsp;A &nbsp;low&nbsp; Ki67 &nbsp;index &nbsp;was &nbsp;present &nbsp;in &nbsp;40 &nbsp;cases &nbsp;of &nbsp;Grades &nbsp;I &nbsp;and &nbsp;II &nbsp;(95.23%)<o:p></o:p></span></p> <p class="MsoNormal" style="margin-right:-34.65pt;text-align:justify;line-height:&#10;150%"><span style="font-size:14.0pt;line-height:150%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">P &nbsp;Value &nbsp;using &nbsp;Fisher&rsquo;s &nbsp;Exact &nbsp;Test &nbsp;= &nbsp;0.0001 &nbsp;(statistically high significant correlation).&nbsp; <o:p></o:p></span></p> <p class="MsoNormal" style="margin-right:-34.65pt;text-align:justify;line-height:&#10;150%;tab-stops:206.25pt"><span style="font-size:14.0pt;line-height:150%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Depending &nbsp;on &nbsp;IHC &nbsp;markers &nbsp;ER, &nbsp;PR, &nbsp;Her-2/neu, &nbsp;and&nbsp; Ki67, &nbsp;molecular &nbsp;subtyping &nbsp;into &nbsp;Luminal &nbsp;A &nbsp;patients &nbsp;were &nbsp;43 (76.78%), &nbsp;Luminal &nbsp;B &nbsp;were &nbsp;10&nbsp;&nbsp; (17.85%), &nbsp;Her-2/neu &nbsp;enriched-1 (1.78%) &nbsp;and &nbsp;Basal &nbsp;like-2&nbsp; (3.57%).<o:p></o:p></span></p>