Role of immunohistochemical markers in breast cancer and their correlation with grade of tumour, our experience

Objectives: To study the immunohistochemical markers in invasive carcinoma of breast and to assess the relationship of hormonal receptors and Her2Neu oncoprotein with grade of tumour. Materials and methods:This was a comparative cross sectional study conducted at Chughtais Lahore lab from Jan 2011-Oct 2011.Eighty two biopsy proven cases of breast carcinoma were reviewed.Immunohistochemistry was used to evaluate the expression of Estrogen receptors(ER) and progesterone receptors (PR) and Her2Neu oncoprotein.Grade of tumour was assessed by Scarf Bloom Richerdson Grading system.Results: This study comprised 82 cases of invasive breast carcinoma.Out of these 82 cases, 2 were males and 80 were females.Majority of the cases were between 25-45 years age group.Fifty seven cases (69.5%) were of grade 2 and 25 cases were of grade 3(30.4% cases).There was no grade 1 tumour in our study.Considering ER, PR and Her2Neu oncoprotein overexpression and grade of tumour, twenty five cases (30.4%) were ER+ PR+ and Her2Neu negative and were all grade 2. Eleven cases (13%) were ER+PR-and Her2Neu-and were grade 2.Only one case(1.2%)was ER-PR+ and Her2Neu-and was again grade 2. Eight cases (9.7%) were tripple negative with grade 3 morphology.Twenty seven cases were ER-PR-and Her2Neu positive (32.9%).Eleven cases were ER-PR-and Her2Neu+ with grade 2 morphology and 16 cases were grade 3.Ten cases (12.1%) were tripple positive having 9 cases with grade 2 morphology and one case with grade 3 morpholgy.Conclusion: Reactivity of steroid receptors decreases with increasing grade.Tripple negative tumours usually exhibit higher grade.Her2 Neu positivity is also associated with higher grade and poor survival rate.