Abstract
Breast cancer is one of the most commonly diagnosed malignancies and leading cause of cancer death in women over the world and the second most common cancer in females in India. Length of survival of cancer patients is an important indicator for knowing the outcome of treatment in any study. As the disease burden and mortality rate is very high, knowing the factors that influence survival rates among women with breast cancer may help design early detection and improve treatment. The immunohistochemistry plays a very important role in prognostication and treatment determination.
 Aim: This study aims to correlate the various relevant prognostic pattern like reactivity pattern of ER,PR,Her-2/Neu ,ki-67 and 2-yr overall survival.
 Material and method: The proposed study was a cross sectional study with mostly prospective observation and with some retrospective observation, included 74 patients of stage II and stage III breast carcinoma who underwent MRM in Chittaranjan National Cancer Institute from 2017-2018. The various clinical and histopathological prognostic parameters with Estrogen/ Progesterone hormone receptors and Human epidermal growth factor receptor (Her-2/Neu) status in invasive breast carcinoma patients were studied and correlated.
 Result: 58.1%, 54.1% and 35.1% of the cases were ER, PR and Her-2/neu positive respectively.
 89.2% of cases had Ki-67 level >20%. Her-2 neu negative, ER negative and KI-67>20% were found to be significant factors for mortality. Maximum (66.7%) of patients with recurrence and maximum (53.8%) patients who died in study period had triple negative breast cancer. Triple negative tumours have poor survival as compared to ER + PR + and HER-2/Neu +ve tumours. Disease free survival and overall survival of the patients with Ki-67< 20% was better than that of patients with Ki-67>20% (100%).
 Keywords: Breast cancer, Invasive ductal carcinoma, ER,PR,HER-2/Neu , Ki-67 , Two year survival.
Highlights
Prognosis of breast cancer can be assessed by following factors such as; risk of aggressiveness, faster death or recurrence and shortened disease free survival or overall survival
Hormone receptors are ER, PR, molecular based markers are like oncogenes, protooncogenes(eg.HER-2/Neu) and tumor suppression gene P-53, proliferative marker,apoptosis gene(Bcl-2) and cell cycle regulators.Evaluation of ER, PR and HER-2 expression by IHC is routinely performed in breast carcinoma
Study population: 74 Patients those who were getting operated in our hospital for breast Carcinoma were selected for this study after getting proper consent and most importantly after histopathological confirmation of Invasive Ductal Carcinoma( stage II and III)as a diagnosis and those having known ER,PR,HER-2/neu and ki-67 status were included in this study
Summary
Prognosis of breast cancer can be assessed by following factors such as; risk of aggressiveness, faster death or recurrence and shortened disease free survival or overall survival. Prognosis of breast carcinoma is dependent on clinical factors, histopathological parameters, hormone receptors and molecular based markers. Hormone receptors are ER, PR, molecular based markers are like oncogenes (eg.myc), protooncogenes(eg.HER-2/Neu) and tumor suppression gene P-53, proliferative marker (eg.Ki67),apoptosis gene(Bcl-2) and cell cycle regulators (eg.cyclins).Evaluation of ER, PR and HER-2 expression by IHC is routinely performed in breast carcinoma. Estrogen receptor status is regarded at present as the most powerful predictive marker in breast cancer management. Several authors have reported that patients with ERpositive tumor have a longer disease-free survival than the others. HER-2 is individually associated with poor survival in breast carcinoma but nothing has been proved conclusively to be the best in survival of breast carcinoma in India
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