Evaluation of hormone receptors status (estrogen and progesterone)‎ and human epidermal growth factor receptor R-2 (HER2)‎ in breast cancer in Basrah

الملخص EN

Background : breast cancer is a complex disease that demands awareness by both physicians and patients.

It is the most common type of malignancy among Iraqi women.

Hormone receptors, Estrogen, Progesterone (ER and PR) and Human Epidermal Growth Factor Receptor-2 (HER-2) have a great influence on the clinical outcome of breast cancer.

The role of hormone receptors and HER2 as a prognostic factor has a wide acceptance in the management of breast cancer.

Aim of the study: To evaluate hormone receptor status in breast cancer cases in Basrah and to correlate them with other clinicopathological parameters of breast cancer.

Patients and methods: Seventy six cases of breast cancer (mastectomy specimens) were collected.

Formalin fixed and paraffin embedded (FFPE) histological sections stained by hematoxylene and eosin (H&E) and graded according to the Modified Nottingham grading system (NGS).

Immunohistochemical (IHC) staining of FFPE sections and scoring for ER, PR and HER2 were done according to the DAKO Cytomation protocol using the Labelled Streptavidin Biotin system (LSAB).

Results : the majority of patients were less than or equal to 50 years old (60.5 %) with a mean age of 48 years.

The leading tumor type is infiltrative ductal carcinoma (89.5 %).

The majority of patients are presented with grade II (72 %) and stage IIA (40.8 %).

The percentage of ER + ve tumors is (55%) followed by PR + ve (48.7 %) and HER2 +ve (30 %).

A significant positive correlation is found between ER, PR and age (P value 0.02) and a significant negative correlation between ER, PR and grade of tumor (P value 0.01).

Also a negative correlation between ER, PR and stage of tumor is found, however this association is statistically not significant (P value 0.1).

No significant association between HER2 with age and grade is found; but a significant positive relationship is shown between HER2 and stage of tumor (P value 0.01).

An inverse correlation between ER and HER2 was just statistically significant (p value 0.05) while no significant association between PR and HER2.

ER + ve / PR + ve / HER2 – ve tumors (PPN) account for higher percentage among subgroups of breast cancer (30 %) and frequently occur in the early grade and stage, followed by triple negative tumors (NNN) 19.7 % which are mainly found in grade III and stage III tumor.

Conclusion : breast cancer in our locality is characterized by an early age occurrence with a moderately advanced grade and stage at presentation.

Hormonal status is nearly similar to that reported in other studies.

ER + ve / PR + ve (PPN) tumor is associated with earlier grade and stage than that of triple negative tumor (NNN).

(MJBU, 30, 2 : 2012, Page 133-142).