Title: A Study of Histomorphological Prognotic Factors and Hormone Receptor Status in Therapeutic Decision Making in a Case of Carcinoma Breast

Authors: Dr S.J. Bhosale, Dr Rajath Rakshit.R

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.169

Abstract

Background and Introduction: Carcinoma breast is the most common cause of malignancy related mortality in developed countries in our country it is the second most common malignancy. Hormones such as estrogen,progesterone play a vital role in functioning and regulation of  epithelial lining of the breast and endometrium. Estrogen and progesterone receptor status is a very important predictive marker in prognosis of the malignancy.

Aims and Objective: To study the  histomorphological prognostic factors such as, tumorsize, histological type number of positive axillary lymph nodes, histological grading and correlate with ER/PR status and their role in systemic therapy decision making.

Materials and Method: The study included 110 patients who were admitted with diagnosis of carcinoma breast in surgical wards of Krishna hospital, their histomorphological prognostic factors were studied by histopathological examination and  ER/PR status studied by immunohistochemistry and correlated, staging was done for the therapeutic decision making. This study was done over the period from October 2016 to June 2018.

Results: Patients with low Grade tumors (I and II),smaller tumor size, less positive axillary lymph nodes and showed ER/PR positive status .Age was an important factor, ER/PR status was more negative in younger age group, Poorly differentiated tumors (Grade III) showed ER/PR negative status irrespective of the age.

Staging of the tumor was done in order to facilitate the theraptic decision making, out of which majority of patients(50.00%) would benefit only from hormonal therapy,(40.00%) would need a combination a of hormonal and chemotherapy,(9.00%) of patients would benefit only from chemotherapy.

Conclusion: Patients with both ER/PR positive status showed better grade, less aggressive, fewer positive lymph nodes and showed better prognosis to hormonal therapy as compared to patients with ER/PR negative status.

Hence a combination of histopathological and immunohistochemistry studies provides a valuable predictive tool for the prognosis of the patient with carcinoma breast.

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Corresponding Author

Dr Rajath Rakshit.R

PG Student