Concurrent expression of immunhistochemical parameters in breast cancer patients; clinical implications and consistency with Bloom-Richardson grading system

We sought to determine prognostic importance of expression p53, c-erbB-2 (also known HER2/neu or HER2), estrogen receptor and progesterone receptor in breast cancer patients by investigating their relationship with histopathological and clinical parameters. We also investigated whether different parameters other than Bloom-Richardson grading system might be used in classification of breast cancer patients on the basis of concurrent expression of immunhistochemical parameters. Seventy-one invasive ductal carcinoma patients were included. We studied immunhistochemical parameters including, estrogen receptor, progesteron receptor, p53 and c-erbB-2. Specimens that were archived in pathology department were re-assessed to determine necrosis, lymph and blood vessel invasion, perineural invasion, peritumoral inflamatory reaction characteristics. Bloom-Richardson grading system was applied for each specimen. Multivariate discriminant analysis was performed to test the relationship between Bloom-Richardson system and immunhistochemical parameters. Mean age was 50.79 ± 11.92. Forty-eight patients (67.6%) were estrogen receptor positive, 34 (47.9%) were progesterone receptor positive, 38 (53.5%) were p53 positive and 46 (64.8%) were c-erbB-2 positive. Necrosis was less common and peritumoral inflammatory reaction was more common among estrogen receptor positive patients. According to the discriminant analysis, 52.1% of patients with concurrent expression of ER, PR, p53 and c-erbB-2 were correctly classified according to overall Bloom-Richardson grade, 49.3% were correctly classified according to nuclear pleomorphism score and 77.5% were correctly classified according to mitotic count. Prognostic classification of patients could be done on the basis of mitotic characteristics of the tumor. Further study is warranted to establish the standard threshold for mitotic count for breast tumors of different types.

Keywords:

Breast Cancer, İmmunhistochemical markers Bloom-Richardson grading system, Mitotic caunt,

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