A study of expression of Her2/neu in carcinoma breast with reference to clinicopathological features and prognostic index

BACKGROUND : Carcinoma of the breast has clinical heterogeneity with high morbidity and mortality. Determination of prognostic factors is important in improving the overall survival breast cancer patients. Her2/neu is one of the powerful predictors of poor prognosis. Thus a study of Her2/neu expression estimated by immunohistochemistry in breast cancer is the need of the hour. This study investigates correlations between the presence of Her2/neu and various clinicopathological prognostic parameters in primary breast carcinomas. OBJECTIVES : 1. Study of the HER2/neu status in breast carcinomas in the study sample. 2. To find the association of HER2/neu status with clinicopathological prognostic parameters in breast carcinomas in the study sample. 3. To find the association of HER2/neu status with lymph node status. METHODOLOGY : Patients diagnosed as carcinoma breast, admitted in Department of General surgery, Govt. Royapettah Hospital and post operative modified radical mastectomy specimens were examined for gross and microscopic features. Immunohistochemistry was used to study the Her2/ neu expression. Her2/neu status was correlated with various clinicopathological prognostic parameters. RESULTS : There was a significant statistical association between Her2/neu expression with lymph node status(p=0.012) and presenting symptoms such as pain and nipple discharge. Expression of Her2/ neu expression was increased in tumour size of more than 2 cms (64%) and higher tumour grade (90%). The major histological subtype was Infiltrating duct carcinoma, NOS type. Meanwhile there was no significant association of Her2/neu expression with menopausal status, NPI groups and other histological parameters. CONCLUSION : Our study data indicates that Her2/neu may be a more powerful predictor for poor prognosis as its expression is associated with important prognostic parameters like increased tumour size, high tumour grade, high NPI score and lymph node involvement