Assessment of Clinicopathological Profile and Receptor Status of Breast Cancer Patients at a Tertiary Care Centre in Uttarakhand, India: A Prospective Cohort Study

Abstract

Introduction: Breast carcinoma has become a major public health problem among both urban and rural populations in India. The management of breast carcinoma depends on hormone receptor status and the pathological properties of the tissue, which serve as important prognostic markers. Aim: The aim of this study was to analyse the clinicopathological parameters and receptor status in breast cancer patients in the Garhwal Region of Uttarakhand. Materials and Methods: This prospective cohort study involved 51 patients who underwent modified radical mastectomy for breast carcinoma at the Department of General Surgery, Government Doon Medical College, Dehradun, Uttarakhand, India. The study was conducted over a period of two years and seven months, from May 2018 to December 2020. Various parameters such as age, side and quadrant of breast involvement, TNM stage, histological grade, receptor status, molecular subtypes, and axillary lymph node status were evaluated. The data was tabulated using Microsoft Excel 2007. The distribution of various receptors in tumour specimens was compared with clinicopathological variables and expressed as percentages. Results: The mean age of the study participants was 52.54±13.24 years, with a male to female ratio of 2:98. In this study, the majority of females (62.74%) belonged to the age group of 40 to 60 years. Left breast carcinoma showed a slightly higher prevalence (52.94%) than right breast carcinoma (47.05%), and the upper outer quadrant was the most commonly involved (50.98%). Infiltrating ductal carcinoma, not otherwise specified, was the most common histological type observed in all patients. The majority of patients (84.31%) had tumour sizes less than 5 cm. Grade-II tumours were the most frequent grade, observed in 34 cases (66.66%). Among the tumour stages, T2 stage accounted for the highest frequency (67%), followed by T3. The authors found that the highest frequency of tumours belonged to N0 stage (29.41%), followed by N1, N2, and N3, respectively. The corresponding rates of luminal A, luminal B, triple-negative, and Human Epidermal Growth Factor Receptor 2 (HER-2)/neu enriched subtypes were 5 (14.7%), 3 (8.82%), 11 (32.5%), and 3 (8.82%), respectively. The cases negative for Oestrogen Receptor (ER) and Progesterone Receptor (PR) were found to have high-grade disease on histological evaluation. Conclusion: The higher percentage of Grade-II and III tumours observed in this study highlights the need to increase health awareness in this area in order to decrease morbidity and mortality. The study recommends that Immunohistochemistry (IHC) classification serves as an important prognostic factor in breast cancer patients.