The Value Of Immunohistochemical Expression Of Estrogen Receptor And Progesterone Receptor Receptors In The Prognosis Of Iraqi Women With Breast Carcinoma

Abstract

Background: The basic microscopical structure of the adult female breast is composed primarily of two components. The first is an active adipocyte (mesenchyme). The second is an epithelial bilayer, which is supported by Cooper ligaments (a loose framework of dense fibrous connective tissue). Immunohistochemical evaluation of breast tissue is of diagnostic, prognostic, and therapeutic relevance. Estrogen receptor (ER) and progesterone receptor (PR) are playing a vital role in the management of breast cancer because they predict response to endocrine treatment; however, they have a little prognostic role regarding the fate of disease. These receptors had assessed by immunohistochemistry (IHC) that had performed on paraffin tissue preparations. Aim of the study: The current study was aiming at highlighting the value of immunohistochemical expression of ER and PR receptors in the prognosis of Iraqi women with breast carcinoma. Materials and methods: The current study was carried out at the central laboratory of Al-Diwaniyah teaching hospital and several private histopathology laboratories in Al-Diwaniyah province, the mid-Euphrates region of Iraq. The study was started in July 2019 and ended in February 2020. Thirty-paraffin sections of breast carcinoma had retrieved from these laboratories. One-section had been made from each paraffin block and stained by the conventional hematoxylin and eosin (H and E) stain. Then, the sections had reviewed by two pathologists, who confirmed the diagnosis, as well as the other related histological features like grade, histological subtype, stromal invasion, and lymphatic and neural permeation. Two-further sections had made for immunohistochemical staining with ER and PR receptor stains. Results: The immunohistochemical expression of ER and PR receptors was as following: Positive ER only cases were 3 (10.0 %), positive PR only cases were 4 (13.3 %), and the cases which were positive for both ER and PR were 15 (50.0 %). The Cases that were negative for both ER and PR accounted for 8 (26.7 %). Total cases expressing ER accounted for 18 (60.0 %), and the cases that express PR had accounted for 19 (63.3 %). Conclusion: The immunohistochemical expression of ER and PR receptors is heterogeneous concerning the proportion and intensity of staining, and this may explain the variation of breast cancer cases in response to hormonal therapy.