Study of ER (Estrogen Receptor), PR (Progesterone Receptor) & HER- 2/NEU (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-based classification of both Estrogen Receptor/Progesterone Receptor and Human epidermal growth factor receptor/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 : 43 patients with breast neoplasm who were diagnosed to have carcinoma breast, after undergoing preliminary FNAC/Trucut biopsy/open biopsies and subsequently underwent Modified radical mastectomy were included in the study. The surgical specimen were then evaluated histopathologically and immunohistochemically for ER, PR, HER-2/neu markers. Results: Out of 43 cases studied, Majority of the cases {41cases (95.34%)} were of Invasive ductal carcinoma. Grade I tumors were seen in patients more than 60 years of age implying a better prognosis.Percentage of  ER positivity was 39.5%, PR positivity was 41.8%, Her2/Neu positivity was 32.5%. Only case was triple positive for all the three markers (ER/PR+ Her2+) which was in the 71-80 yrs age group implying a better predictive response to hormonal therapy. Conclusion : From the present study it was concluded that with incorporation of Immunohistochemistry-based classification of both ER/PR and HER-2/neu status into the histopathology report using 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.