Abstract
Background: Estrogen receptor (ER), Progesterone receptor (PR) and Her2Neu expression status have important roles in prognosis and treatment of breast cancer. This study aims at correlating clinical and pathological features of breast cancer patients with its intrinsic subtypes.
Methods: 100 patients of breast cancer undergoing modified radical mastectomy were selected for the study. Four subtypes based on immunohistochemistry evaluated ER/PR/HER2 status, clinicopathological features, and prognosis were analyzed retrospectively and statistically.
Results: The following distribution was observed : luminal A subtype( ER+, PR+, Her2neu-) – 34 cases, luminal B subtype( ER+,PR+, Her2Neu+) -13 cases, Her2neu enriched (ER-, PR-, Her2Neu++)- 20 cases, basal subtype(triple negative)-33 cases. The clinical features like age, menarche age, parity, years of lactation and presence of risk factors were strongly correlated to breast cancer intrinsic subtypes (p <0.05) while pathological factors like proliferative index is strongly correlated to breast cancer intrinsic subtypes(p<0.05).
Conclusion: Breast cancer intrinsic subtypes are associated with its clinical and pathological features. This association can be helpful in treatment modification of patients with long term follow up. Study also shows the importance of NPI as a correct prognostic indicator and guide for planning adjuvant therapy that uses tumor size, nodal status and tumor grade.
References
- Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2000: Cancer Incidence, mortality and prevalence worldwide. IARC Cancer Base No. 5. 2001, Lyon, France: IARC.
- Yeole BB, Kurkure AP. An epidemiological assessment of increasing incidence and trends in breast cancer in Mumbai and other sites in India, during the last two decades. Asian Pac J Cancer Prev 2003;4: 51-6.
- Dr Narayan Das, Dr AnarshDebbarma, Dr Anup kumarSaha.Evaluation of Clinico-Pathological Study of Breast Cancer in Rural PopulationIOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 9 Ver. XI (September). 2016), PP 67-69
- Grabrick DM, Hartmann LC, Cerhan JR, et al. Risk of breast cancer with oral contraceptive use in women with a family history of breast cancer. JAMA2000; 284:1791-1798
- Pike MC, Krailo MD, Henderson BE, Casagrande JT, Hoel DG. 'Hormonal' risk factors, 'breast tissue age' and the age-incidence of breast cancer. Nature 1983;303:767-70.
- Adapted from Cancer Genome Atlas network. Comprehensive molecular portraits of human breast tumours. Nature 2012;490:61-70
- Smid M, Wang Y, Zhang Y, Sieuwerts AM, Yu J, Klijn JG, et al. Subtypes of breast cancer show preferential site of relapse. Cancer Res 2008;68:3108–3114.
- Fan C, Oh DS, Wessels L, et al. Concordance among gene-expression-based predictors for breast cancer. N Engl J Med. 355(6):560-9, 2006.
- Kohler BA, Sherman RL, Howlader N, et al. Annual report to the nation on the status of cancer, 1975-2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. J Natl Cancer Inst. 107(6), 2015.
- Sineshaw HM, Gaudet M, Ward EM, et al. Association of race/ethnicity, socioeconomic status, and breast cancer subtypes in the National Cancer Data Base (2010-2011). Breast Cancer Res Treat. 145(3):753-63, 2014.
- Voduc KD, Cheang MC, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H. Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol. 28(10):1684-91, 2010.
- Howlader N, Altekruse SF, Li CI, et al. US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst. 106(5), 2014.
- Schott AF. Systemic treatment for HER2-positive metastatic breast cancer. https://www.uptodate.com/contents/systemic-treatment-for-her2-positive-metastatic-breast-cancer? Last updated Jun 07, 2017. Accessed July 1, 2017.
- Morrow M, Burstein HJ, Harris JR. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’sCancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
- Stead LA, Lash TL, Sobieraj JE, Chi DD, Westrup JL, Charlot M, et al. Triple-negative breast cancers are increased in black women regardless of age or body mass index. Breast Cancer Res. 2009;11(2):1–10.
- Albergaria A, Ricardo S, Milanezi F, Carneiro V, Amendoeira I, Vieira D, et al. Nottingham Prognostic Index in Triple-Negative Breast Cancer: A reliable prognostic tool? BMC Cancer [Internet]. 2011;11(1):299. Available from:http://www.biomedcentral.com/1471-2407/11/291
- Sandhu D, Sandhu S, Karwasra R, Marwah S. Profile of breast cancer patients at a tertiary care hospital in north India. Indian J Cancer [Internet]. 2010;47(1):16. Available from: http://www.indianjcancer.com/text.asp?2010/47/1/16/58853.
- Kosei Kimura, Satoru Tanaka,Mitsuhiko Iwamoto , Hiroya Fujioka , Yuko Takahashi , NayukoSatou, and Kazuhisha Uchiyama ;Association between body mass index and breast cancer intrinsic subtypes in Japanese women. Article in Experimental and therapeutic medicine 4(3):391-396September 2012
- FatanehZeiyaie et al; The relationship of reproductive risk factors and histologic patterns with molecular subtypes of breast cancer International Journal of cancer management: June 2018,11(6); e66746published online:June 9,2018
- Lisa A. Carey, MD; Charles M. Perou, PhD; Chad A. Livasy, MD; et al Race, Breast Cancer Subtypes, and Survival in the Carolina Breast Cancer Study. 2006;295(21):2492-2502
- Xuezheng Sun, Hazel B. Nichols, Chiu-Kit Tse, Mary B. Bell, Whitney R. Robinson, Mark E. Sherman, Andrew F. Olshan, and Melissa A. Troester; Association of Parity and Time since Last Birth with Breast Cancer Prognosis by Intrinsic Subtype, 2015 American Association for Cancer Research
- Xiaohong R.Yang, Mark E.Sherman, David L.Rimm, JolantaLissowska et al; Differences in Risk Factors for Breast Cancer Molecular Subtypes in a Population-Based Study. Cancer epidemiology biomarkers and prevention. March 2007Volume 16, Issue 3
- Godwin A Ebughe et al, Histological; type and tumor grade in nigerian breast cancer: relationship to menarche,family history of breast cancer,parity,age at first birth, and age at menopause IOSRjournal of Dental and Medical Sciences(IOSR-JDMS) e-ISSN: 2279-0853p-ISSN:2279-0861.2013;7(5):58-63.
- I Mehdi et al,breast cancer molecular subtypes in Oman:Correlation with age,histology,and stage distribution-Analysis of 542 cases national oncology center, the Royal Hospital, Muscat, Omangulf journal of oncology, The1(15):38-48.March 2014.
- Siadati S, Sharbatdaran M, Nikbakhsh N, Ghaemian N. Correlation of ER, PR and HER-2/neu with other prognostic factors in infiltrating ductal carcinoma of breast. Iran J Pathol. 2015;10(3):221–6.
- Hongchao Zhen, Liuting Yang, Li Li1, Junxian Yu, Lei Zhao, Yingying Li and Qin Li; Correlation analysis between molecular subtypes and Nottingham Prognostic Index in breast cancer. Oncotarget, 2017, Vol. 8, (No. 43), pp: 74096-74105
- Ivkovic-Kapicl T, Knezevic-Usaj S, Djilas-Ivanovic D, Panjkovic M. Correlation of HER-2/neu protein overexpression with other prognostic and predictive factors in invasive ductal breast cancer. In Vivo. 2007;21(4):673–8.
Corresponding Author
Dipanshu Kakkar
Junior Resident, Department of General and Oncosurgery, Pt. B.D.Sharma, PGIMS, Rohtak
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.16
