Study of morphological features of breast carcinoma in relation to ER/PR status

Breast carcinoma is the most common cancer among women in the urban Indian population and second only to cervical cancer in the rural population. Prognosis is related to a variety of clinical, pathologic and molecular features. Immunohistochemical evaluation of estrogen receptor (ER) and progesterone receptor (PR) status of breast carcinoma has become a routine investigation to predict the response to endocrine therapy.

To study patient and tumor characteristics in relation to estrogen and progesterone receptor (ER & PR) status of the tumor.

This is a retrospective and prospective study of 100 cases of breast carcinoma diagnosed during January 2007 to September 2011 in the department of Pathology, NRI Medical College, and Chinakakani. Clinical details were archived from the files. Routine histological examination and Immunohistochemical analysis of all the cases were done.

Tumors were separated into four categories: ER+PR+ (33%), ER+PR− (15%), ER−PR+ (7%) and ER−PR− (45%). ER and PR immunoreactivity increased with advancing age. 52% of cases were in the right breast. Invasive lobular carcinoma, and papillary carcinoma were more frequently ER+PR+. High-grade infiltrating ductal carcinomas, pure comedo ductal carcinoma in situ, mucinous carcinoma and medullary carcinoma were predominantly ER−PR−. ER & PR immunoreactivity decreased with increasing tumor grade, lymph nodal metastasis, presence of tumor necrosis, desmoplasia and lymphovascular emboli.

Histological grading together with receptor status offers an excellent method of predicting the prognosis and response to hormonal therapy which lightens up a prospect of various treatment modalities.