A study of triple negative breast carcinomas

Aim and objectives: To show the incidence of triple negative breast carcinomas in the younger age group (20-40 years) in the study sample and to establish a correlation between expression patterns of estrogen receptor (ER), progesterone receptor (PR) and HER2 /neu with tumour histopathology of breast carcinoma. Material and methods: A 5 years study, 2 years retrospective and 3 years prospective was conducted in Mahatma Gandhi Memorial Hospital, Warangal, from 2009 to 2014 on triple negative breast carcinomas. All the mastectomy specimens, received in the Pathology Department during this period were considered. Results: Total of 28 cases of carcinoma breast in females diagnosed histopathologically, were included in the study. In the present study, the patients were in the age group of 20-40 years since most carcinomas in this age group are triple negative. Most of the tumours were of size > 5 cm, 12 cases (43%), followed by 10 cases (36%) of size 2-5 cm. Total 20 (71.4%) were IDC (NOS), followed by 4 (14.2%) were Medullary carcinomas and 2 (7.1%) cases of ILC and each 1 (3.6%) case of tubular and Mucinous carcinomas. Histopathological grading was done according to Modified Bloom Richardson grading and found that 11 (39.3%) were of grade II followed by 5 (17.9%) cases were grade III, 4 cases were of grade I and 8 cases were inassessible. ER and PR were positive in 61% and 47% of tumors respectively. HER-2 over expression was seen in 36% of tumors and was negative in 64% of tumours. Triple negative carcinomas were 4 out of 28 cases, of which 3 were IDC (NOS) and 1 was medullary carcinoma. Triple negative carcinomas are associated with poor prognosis. Conclusion: ER, PR and HER-2 status correlates well with histopathological grading and other clinico-pathological parameters. Higher grade is associated with HER-2 positivity and ER/PR negativity, larger tumor size, lympho-vascular invasion, lymph node metastasis, and higher clinical stage.