Citation Information :
Kapoor T, Singh G, Loyal A, Sharma J, Singh DP. Breast Cancer Tumor Biology Characteristics and Its Correlation in a Tertiary Care Center. J Mahatma Gandhi Univ Med Sci Tech 2021; 6 (2):53-55.
Aims/Objectives: The study aims to evaluate and correlate the relationship between hormone receptor status—estrogen, progesterone receptor (ER and PR), and Herceptin receptor (Her-2/neu) with tumor characteristics in breast cancer patients.
Materials and methods: The current study included 101 breast cancer patients of various age-groups from the period 2016–2020. The tumors were evaluated for hormone expression, size, histologic grade, lymphovascular invasion, and axillary node status. The excised breast tissue specimen was evaluated for hormone status by immunohistochemistry (IHC) testing on paraffin blocks and was further analyzed using the fluorescence in situ hybridization (FISH) technique as per requirement. Stratification based on hormone receptor status was done in four categories—ER+PR+Her-2neu−, ER−PR−Her-2neu+, ER+PR+Her-2neu+, and ER−PR−Her-2neu−.
Results: In this study, 37.6% of tumors were ER+PR+Her-2neu−, 13.8% ER−PR−Her-2neu+, 13.8% ER+PR+Her-2neu+, and 34.6% ER−PR−Her-2neu−. Among high-grade tumors, more than half (52%) patients were hormone receptor-negative, whereas among low-grade tumors 55% of patients were hormone receptor-positive. Sixteen percent of patients presented with a younger age-group (<35 years) and in these patients, nearly 38% were Her-2/neu positive and most of the Her-2/neu receptor-positive patients (80%) had lymphovascular space invasion. Primary tumor size at time of presentation was <2 cm (T1) in only 11% of cases and 2–5 cm (T2) in 72% of cases. Lymph node positivity did not correlate with hormone receptor status.
Conclusion: The incidence of Her2-neu positive breast cancer patients was higher in the Indian population as compared to the Western world. The current study depicts the distinct shift in terms of tumor stage and biology, higher rate of Her-2/neu-positivity, younger age at diagnosis, larger tumor size, advanced tumor grade, and more positive lymph node involvement in contrast to the Western population.
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424. DOI: 10.3322/caac.21492.
Globocan 2018: India Factsheet. http://cancerindia.org.in/globocan-2018-india-factsheet.
Desai SB, Moonim MT, Gill AK, et al. Hormone receptor status of breast cancer in India: a study of 798 tumours. The Breast 2000;9(5):267–270. DOI: 10.1054/brst.2000.0134.
Kakarala M, Rozek L, Cote M, Liyanage S, et al. Research article breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S. - a SEER analysis. BMC Cancer 2010;10(1):191. DOI: 10.1186/1471-2407-10-191.
Deapen D, Liu L, Perkins C, et al. Rapidly rising breast cancer incidence rates among Asian-American women. Int J Cancer 2002;99(5):747–750. DOI: 10.1002/ijc.10415.
Lin CH, Liau JY, Lu YS, et al. Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia. 2009;18(6):1807–1814. DOI: 10.1158/1055-9965.EPI-09-0096.
Pathmanathan N, Geng J, Li W, et. al. Human epidermal growth factor receptor 2 status of breast cancer patients in Asia: results from a large, multicountry study. Asia-Pacific J Clin Oncol 2016;12(4):369–379. DOI: 10.1111/ajco.12514.
Yarden Y, Sliwkowski MX. Untangling the ErbB signalling network. Nat Rev Mol Cell Biol 2001;2(2):127–137. DOI: 10.1038/35052073.
Weigel MT, Dowsett M. Current and emerging biomarkers in breast cancer: prognosis and prediction. Endocr Relat Cancer 2010;17(4):R245–R262. DOI: 10.1677/ERC-10-0136.
Press MF, Pike MC, Chazin VR, et al. Her-2/neu expression in node-negative breast cancer: direct tissue quantitation by computerized image analysis and association of overexpression with increased risk of recurrent disease. Cancer Res 1993;53(20):4960–4970.
Gupta S, Shet T, Suryavanshi P, et al. Estrogen, progesterone and HER2 receptor expression in breast tumors of patients, and their usage of HER2-targeted therapy, in a tertiary care centre in India. Indian J Cancer 2011;48(4):391–396. DOI: 10.4103/0019-509X.92245.
Shousha S, Coady AT, Stamp T, et al. Oestrogen receptors in mucinous carcinoma of the breast: an immunohistological study using paraffin wax sections. J Clin Patho 1989;42(9):902–905. DOI: 10.1136/jcp.42.9.902.
Akiyama F, Iwase H. Triple negative breast cancer: clinicopathological characteristics and treatment strategies. Breast Cancer 2009;16(4):252–253. DOI: 10.1007/s12282-009-0140-x.
Vedashree M, Rajalakshmi V. Clinico-pathological study of breast carcinoma with correlation to hormone receptor status and HER-2/neu. Indian J Pathol Oncol 2016;3(4):690–695. DOI: 10.5958/2394-6792.2016.00128.9.
Lal P, Tan LK, Chen B. Correlation of HER-2 status with estrogen and progesterone receptors and histologic features in 3,655 Invasive breast carcinomas. Am J Clin Pathol 2005;123(4):541–546. DOI: 10.1309/YMJ3A83TB39MRUT9.
Kulkarni A, Kelkar DA, Parikh N, et al. Meta analysis of prevalence of triple-negative breast cancer and its clinical features at incidence in Indian patients with breast cancer. JCO Global Oncol 2020;6(6):1052–1062. DOI: 10.1200/GO.20.00054.