What question did this study set out to answer?

The study aims to explore how the expression of ER, PR, HER-2/neu, and Ki-67 correlates with Nottingham tumor grades in breast cancer tissue.

June 20, 2026

Association of Expression Patterns of ER, PR, HER-2/neu and Ki67 with Nottingham Tumor Grade in Breast Cancer Biopsies

Key Points

The study aims to explore how the expression of ER, PR, HER-2/neu, and Ki-67 correlates with Nottingham tumor grades in breast cancer tissue.
Cross-sectional study of 876 breast carcinoma cases from January 2020 to December 2024.
Used immunohistochemistry to assess expression of ER, PR, HER-2/neu, and Ki-67.
Analyzed data with Pearson correlation and chi-square tests.
Grade II tumors were found in 50.7% and Grade III tumors in 48.7% of cases.
ER positivity was 50.9%, PR positivity was 35.5%, and HER-2/neu positivity was 51.6%.
Ki-67 showed a strong positive association with higher tumor grades, especially grade III (p<0.001).

Abstract

Objective: To examine the association of expression patterns of ER, PR, HER-2/neu, and Ki-67 with Nottingham tumor grade in breast cancer biopsies. Methodology: This was a cross-sectional study, which included 876 histologically confirmed breast carcinoma cases at Meezan Lab, Faisalabad, from January 2020 to December 2024. The Nottingham (modified Scarff-Bloom-Richardson) grading system was used to grade tumors. ER, PR, HER-2/neu, and Ki-67 were all subjected to immunohistochemistry. Pearson correlation and chi-square tests were performed, with p-values <0.05 considered statistically significant. Results: The majority of patients were in the 40–50-year age range. The most frequent histological subtype was invasive ductal carcinoma (91.2%), and the most common tumors were Grade II (50.7%), followed by Grade III tumors (48.7%). The positivity rates of ER and PR were 50.9% and 35.5%, respectively, while that of HER-2/neu was 51.6%. A high Ki-67 proliferation index was mostly found in higher-grade (grade III) tumors. Nottingham grade had a significant positive association with ER (p<0.001), PR (p<0.001), HER-2/neu (p=0.013), and Ki-67 (p<0.001). Ki-67 had the strongest association with tumor grade. KEYWORDS: Breast cancer; Estrogen receptor; HER-2/neu; Immunohistochemistry; Ki-67; Nottingham grade; Progesterone receptor

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