Study of Estrogen Receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor Expression by Immunohistochemistry in Breast Carcinoma

Introduction: Over the last few decades there have been outstanding advances in breast cancer management leading to early detection and treatment of disease. Recent attention has been directed to immunohistochemistry (IHC) based classification of Estrogen Receptor (ER) / Progesterone Receptor (PR) and Human epidermal growth factor receptor/neu (HER2-neu) status which provides prognostic and therapeutic information and is inexpensive and readily available. Aim: The present study was undertaken with the view of correlating the histopathology of the tumor by way of tumor grade, various traditional prognostic markers and its immunohistochemistry profile with respect to Estrogen/Progesterone hormone receptors and Human epidermal growth factor receptor/neu status. Material and Methods: An observational study was conducted in the Department of Pathology, BKL Walawalkar Rural Medical College for two and half year from January 2015 to June 2017 including all the cases of breast carcinoma diagnosed on histopathology on Modified Radical Mastectomy (MRM) specimens and needle core biopsy. The cases with no prior oncological treatment and having complete clinical data were included and the cases with non-malignant conditions of breast were excluded. A total of 134 cases were studied. The surgical specimens were then evaluated immunohistochemically for ER, PR, HER2-neu markers.Results: Out of 134 cases studied, majority of the cases (92.5%) were of Invasive Breast carcinoma, No special type. Women of 31-50 years are more prone to the risk of the development of breast carcinoma. Grade III tumors were seen predominant with 56.67%. implying a poor prognosis. Percentage of ER positivity was 41.04%, PR positivity was 24.6%, Her2-Neu positivity was 26.9% and triple negative was 41.04%. Grade 3 tumor and triple negative cases indicate poor prognosis and poor outcome. Conclusion: From the present study it was concluded that with incorporation of immunohistochemistry based classification of both ER/PR and HER2-neu status into the histopathology report along with the traditional TNM staging and histological grading of breast carcinoma help in better therapeutic management and increases prognostic accuracy and is inexpensive and readily available.