Association between Immunohistochemical profile and Clinicopathological appearance in Breast Cancer : A 7 year review from Mahdieh Radiotherapy Center, Hamadan, Iran

Kamal Mohammadian, Abdolazim Sedighi Pashaki, Ehsan Akbari Hamed, Sepideh Behnood, Mohammad Abassi, Mohammad Babaei, Afsaneh Madah Safaee, Tayebeh Torkaman

Abstract


164

Introduction:

invasive breast cancer is the most common carcinoma in women and it account for 22% of all female malignancies. Breast cancers are a heterogeneous malignancy from a clinical, pathological and therapeutically view and it is no longer seen as a single disease but rather a multifaceted disease. Now a day immunohisto chemistry classification plays a key role in prognostic identification and prediction of outcome. Based on recent gene expression studies, Immunohistochemical subtypes definition as Luminal A (ER+ and /or PR+, HER2- ), luminal B (ER+ and /or PR+, HER2+) , HER2+/ ER- , PR- , based like (ER-, PR-, HER2-). These molecular differences have been shown to correlate with clinical features, such as survival and treatment sensitivity. This study reports our attempt to sub classify breast carcinomas according to specific immuno profile and evaluating the association between different subtypes with histological type, grade, tumor stage, lymph node positive ratio, lymph node status, recurrence and survival.

Material and Methods

The clinical records from 580 patients treated at the Mahdieh Institute of oncology in Hamadan, Iran for breast cancer between Oct 2004 and Oct 2011 were retrieved. Clinic pathological data, including age, size, grade, histology, occurrence of lympho vascular invasion, peri neural invasion, auxiliary lymph node status, hormone receptor and HER2 status, p53 index, loco regional recurrence, distant metastases, disease free survival (DFS), overall survival (OS) were recorded in a database.

Results:

Final analysis included 580 invasive breast cancer patients identification in the Mahdieh center from Oct 2004 to Sep 2011. the mean age was 47.22 (±11.1; range 23 to 93 years). Baseline characteristics of patients including tumor subtypes are presented in table 1. Of 573 patients, 116 (20.2%) were ER /PR+, HER2+, 257 (44.9%) were ER /PR+, HER2- , 72 (12.6%) were ER /PR- , HER2+ , 124 (21.6%) were ER /PR- , HER2- and 4 were not undefined. The estimated median follow up period for all subjects was 4.9 years (range 3 months to 6.9 years). The overall survival for all patients was 88.21% and the disease free survival was 83.7%.

Discussion:

The amazing result from this study was the lower incidence of positive axilary lymph nodes in triple negative subtypes in contrast to other published literatures. Five years relative survival rates were higher for patients with ER/PR+ and negative lymph nodes (p< 0.05).

. Our study is of value because of adequate number of cases, it reflects most of breast cancer patient’s record in west of Iran and it highlights the importance of immunohistochemical subtypes.

Keywords: Breast Cancer, mmunohistochemical, chemotherapy, survival


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References


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