Saudi Journal of Pathology and Microbiology (SJPM)
Volume-4 | Issue-03 | 233-239
Original Research Article
Is It Time to Bid Adieu to the Traditional Histological Prognostic Parameters in Breast Carcinoma? Not Yet
Dr. Ghazala Rizvi, Dr. Prerna Tamta, Dr. Ranjan Agarwal
Published : March 31, 2019
Abstract
Introduction – With the coming of adjuvant hormonal therapy, evaluation of hormone receptors now plays a pivotal role
in the therapeutic management in breast carcinoma. HER2/neu positive tumors are resistant to tamoxifen based therapies.
With the advent of Trastuzumab, the prognosis of this subset of tumors has improved. In this bewildering array of
prognostic factors, the conventional prognostic histological features seem to have lost their importance. Material and
methods- Fifty cases of mastectomy performed for breast carcinoma were taken in the study. Immunohistochemistry was
performed for ER, PR and HER2/neu. Correlation between them and the conventional histological prognostic features
was studied. Chi square test was used for statistical analysis. Results- ER, PR showed a statistically significant positive
correlation with each other. PR & HER2/neu showed no correlation with tumor size whereas ER showed a statistically
negative correlation with size of the tumor. An inverse correlation was seen between tumor grades, mitotic count and ER,
PR. HER2/neu showed no correlation with either grade or mitotic count though a significant positive correlation was
seen with nuclear pleomorphism. Neither the hormone receptors not HER2/neu showed any correlation with lymph node
status. Conclusion- Histological features are still valuable in judging the prognosis of breast carcinoma. Triple negative
and ER+PR- tumors are unresponsive to systemic adjuvant hormone therapy. In addition cost and availability can be
limiting factors in applicability of these tests especially in low socioeconomic conditions and resource limited centers.