Neu Positivity Research Articles

Association between ER and HER2neu status with various sonographic findings in breast cancer

Diagnostic ultrasonography is often used as a radiological modality for assessing clinically or radiologically suspected mammary lesions based on certain radiological criteria. This study was conducted to investigate an association between breast sonographic findings and biological markers (ER and HER2\NEU). The study enrolled 100 histological sample of invasive mammary carcinoma diagnosed by core needle biopsy, 52% from the right breast and 48 % from the left one , age range of patient was from 28 to 80 years with a mean age was 53 years. 64 % were estrogen receptor positive, 54% were HER2\NEU positive. There is a significant statistical correlation between ER and HER2\NEU positivity with the simultaneous presence of axillery lymph node metastasis. While there is a non statistical relashioship between ER and HER2\NEU positivity with various sonographic findings in invasive mammary carcinoma. Thus, breast ultrasound based findings are of no help to predict ER and HER2 status of invasive mammary carcinoma.

Molecular Classification of Breast Carcinoma in a Tertiary Hospital of India: the Recent Trends.

Breast cancer is a heterogeneous disorder with various subcategories of different cellular compositions, molecular alterations, and clinical behaviour and is dependent on numerous factors like grade, size, and hormonal receptors which influence the overall prognosis and response to the treatment. This study was done to determine the frequency of estrogen receptor (ER), progesterone receptor (PR), and Her2 neu positivity in breast cancer patients, further classifying them into their molecular types (luminal A, B, Her2 neu, and triple-negative) and studying their association with histological subtypes, lymph node status, and other epidemiological parameters. This was a 5-year retrospective study done on 314 patients. All relevant clinical data including the age, sex, and lymph node status along with the histological type and grade of the tumour were recorded, and immunohistochemical evaluation of Her2 neu, ER, and PR receptors was done. The results showed that ER was the most predominant immunomarker, followed by PR, with an inverse relationship between ER, PR, and Her2 neu. Among the molecular subtypes, luminal B showed the maximum prevalence followed by triple-negative and Her2 neu subtype. The least frequency was shown by luminal A. Our study concluded that molecular subtyping of breast carcinoma plays an important role in determining the prognosis, recurrence, and treatment. Increased expression of luminal B subtype can be correlated due to the advancing age of the patients.

Whole-body Positron Emission Tomography (WBPET) Scan in All Patients of Breast Cancer: Is This the Way Forward?

Objectives: Globally, breast cancer is the second most frequently diagnosed malignancy just behind lung cancer, accounting for over 2 million cases each year. It is the second most commonly diagnosed cancer worldwide and the most common malignancy among females in India. The role of whole-body positron emission tomography (WBPET) in all cases of breast cancer is still not clear. This pilot study was undertaken to study whether there is any change in the management of breast cancer using WBPET scan in all patients of breast cancer irrespective of the stage? Materials and Methods: We retrospectively reviewed the data of 43 patients with invasive breast cancer who were newly diagnosed at Malignant Disease Treatment Centre at a tertiary care centre in East India. The duration of the study was between June 2020 and March 2021. Patients underwent liver function test, mammography, breast ultrasound, bone scan, and tru-cut needle biopsy to confirm the presence of breast cancer and 18F-fluoro-Dglucose (FDG) positron emission tomography/computed tomography (PET/CT) was studied in all 43 patients before the initiation of any therapy. The primary objective was to find out whether doing a WBPET upstaged the disease and changed our management. The secondary objective was to determine whether hormonal status (oestrogen receptor [ER], progesterone receptor [PR] and human epidermal growth factor receptor 2 [Her2] Neu) and Breast Imaging-Reporting and Database System (BIRADS) score staging had any correlation with metastasis. Results: A total of 43 patients with newly diagnosed breast cancer were studied. The number of patients in Stage IIA (3/43), Stage IIB (4/43), Stage III A (17/43), Stage IIIB (13/43), and Stage IV was (6/33). Out of total 43 patients, in 10 (23%) patients, there was a change in treatment on doing an upfront WBPET scan. There was no correlation between ER, PR, or Her2 Neu positivity or negativity on the upstaging of the disease and change in treatment. Standardised uptake value (SUV) uptake of the primary lesion >7.2 was associated with upstaging and change of treatment. Conclusion: The use of 18F-FDG PET/CT has been shown to bring change in treatment in almost 20% of patients with breast cancer. Although the role of other variables in breast cancer such as hormone status, SUV of the primary lesion, and grade of lesion on BIRADS has also shown some association with change of treatment.

Alteration in key oncoprotein expression in gastric adenocarcinoma - An immunohistochemical study.

This study was conducted to evaluate the frequency and clinicopathologic correlates of human epidermal growth factor receptor 2 (HER-2)/neu and betacatenin (BC) oncoproteins in gastric adenocarcinoma and to seek correlation if any between their expression status. This cross-sectional analytical immunohistochemistry (IHC) study was performed on 50 cases of gastric adenocarcinoma. HER-2/neu immunoexpression was scored as per criteria by Ruschoff et al. as positive (3+), equivocal (2+), and negative (1+, 0). Aberrant BC expression was categorized as nuclear, cytoplasmic, and reduced membranous immunoexpression. Protein expression results of both oncoproteins were correlated with conventional clinicopathological parameters. Correlation between immunoexpression profiles of both proteins was also analyzed. P <0.05 was considered statistically significant. HER-2/neu positivity (2 + and 3+) was seen in 94% of the cases; almost 60% had strong (3+) expression. All cases showed aberrant BC immunoexpression (any pattern) except 2 cases that revealed negative expression (a form of aberrant immunoexpression) and were removed from analysis due to a very small number. The pattern of BC expression was as follows: nuclear expression (38%), cytoplasmic expression (82%), reduced membranous expression (96%), no staining (4%) cases. HER-2/neu expression correlated with age. No significant correlation was found between any of the 2 oncoprotein immunoexpression and other clinicopathological parameters (P > 0.05). Concordance between protein expression of HER-2/neu and BC was seen in >93% cases, however, the correlation was not significant. HER-2/neu and BC oncoprotein expression are frequently dysregulated in gastric adenocarcinomas. The significance of pathways involving HER-2/neu and BC in gastric carcinogenesis should be explored.

Correlation of immunohistochemistry markers in breast carcinoma with biological characteristics and tumor grade as histopathological prognostic parameters

Background: Prognosis of breast cancer and success of therapeutic interventions largely rely on clinico-pathologic and biological characteristics of tumor and vary due to the heterogenous nature of breast cancers. This study was intended to find correlation between the expression of Estrogen receptor (ER), Progesterone receptor (PR) and Human Epidermal Growth Factor Receptor-2 (HER-2/neu) with histological grade in case of carcinoma of breast. Material and Method: This study was conducted on 56 histologically confirmed specimens of breast carcinoma in Department of Pathology, Surat Municipal Institute of Medical Education and Research. Results: Maximum number of cases of breast carcinoma were found in 41-50 years aged females. Invasive ductal carcinoma-not otherwise specified (IDC-NOS) (82.14%) was most common histological type. Most of the carcinoma showed grade II (62.5%). ER, PR and HER-2/neu positivity was 50%, 42.86% and 42.86% respectively. Conclusion: Evaluation of ER, PR and HER-2/neu status and tumor grade should be incorporated routinely as a part of histopathological reports in all cases of breast carcinoma as they not only help in histopathologic assessment of prognosis, but also help in deciding the management thereby improving overall survival.

To Study Clinicopathological and Immunohistochemical Expression of Estrogen Receptor, Progesterone Receptor and Her-2/Neu in Prostate Carcinoma

Background: Prostate carcinoma is leading cause of cancer related deaths amongst men. This study evaluated expression of ER, PR, HER-2/neu in Prostatic carcinoma and its correlation with Gleason score and other clinical parameters.&#x0D; Methods: 50 histopathologically proven PCa cases were subjected to IHC for ER, PR, HER-2/neu.&#x0D; Result: Most common age group involved was 61-80years. Retention of urine was most frequent complaint. Most prominent Gleason score was (3+4) and group grade was 2. ER expression in tumor epithelial cells was 24% and in stromal cells was 36%. PR expression in stromal cells was 32%. HER-2/neu Cytoplasmic positivity was seen in 6% cases. It was seen that with increase in Gleason grade, ER, PR, HER-2/neu positivity was decreased.&#x0D; Conclusion: ER, PR, HER-2/neu can be used as biomarkers in PCa management.

Added Metformin to Systematic Neoadjuvant Chemotherapy in Breast Cancer Patients: Randomized Study from Egypt

Abstract Background: Rational of the neoadjuvant chemotherapy can significantly decrease the size and stage of tumor for breast carcinoma. Studies have demonstrated that there is a greater long-term outcome in patients who reach pathological complete response (pCR) following neoadjuvant therapy. Metformin, a biguanide agent, is used as first-line therapy for the treatment of type II Diabetes. The studies reported that diabetic patients with metformin-administered breast cancer and neoadjuvant chemotherapy had a higher pCR rate than diabetics without Metformin. Aim of Study: To assess the efficacy of incorporating Metformin to standard neoadjuvant chemotherapy in breast cancer patients to increase the rate of pathological complete response (pCR). Patients and Methods: From 1/7/2016 to 1/9/2019, a total of 50 patients were enrolled in the study. Breast cancer patients were equally randomized to receive either standard neoadjuvant AC-Paclitaxel or a similar regimen plus Metformin 500mg twice daily until the time of surgery. For reaction & toxicity, patients were evaluated. Results: Concerning all clinical-pathological variables & biological subtypes, there was no statistically significant difference between both arms. Complete clinical remissions were achieved in 19 patients (76%) and 15 patients (60%) respectively for the investigated group and standard group (p-value 0.4). In the investigated group, 19 patients (76%) were referred to have modified radical mastectomy (MRM) and 6 patients (24%) were referred to have complete breast surgical resection (CBS), while in the standard group, 23 patients (92%) were referred to MRM and 2 patients (8%) were referred to CBS. There was no statistically significant difference between the two types of surgery in the two groups (p-value 0.247). The primary endpoint was the pCR rate in the axilla and breast post operatively. Statistical analysis showed certain trend toward higher rate of pCR with the addition of Metforminin the investigated group compared to the standard group (p-value: 0.08). Uni-variate analysis showed significant correlation with pCR in the 2 groups as regard ER and HER-2/neu positivity, (p-value 0.004).The Median DFS at 2 years in our study was 93.25%. Kaplan-Meier survival curves' analysis showed no significant difference between both groups with a DFS of 91.25% in the investigated group arm, and 96.25% in the standard group. Conclusion: The addition of metformin to neoadjuvant chemotherapy has a nearby significant impact on pathological complete response (PCR)in female patients with advanced breast cancer with no significant increased toxicity. Further studiesare recommended to highlight the effect of adding metformin to standard neoadjuvant chemotherapy in ER and/or HER2 positive breast cancer patients.

Hormone Receptors and Her-2/neu Overexpression in Breast Carcinomas in Patients of West African Origin Seen at Lagos State University Teaching Hospital, Nigeria

Breast carcinoma is a disease of utmost concern to the individual, family, and society at large. The current trend in the management of breast carcinoma also involves hormonal therapy. Consequently, the hormone expression of the tumor in the individual involved must be known if he or she is to benefit from such therapy. This is a prospective study of estrogen and progesterone receptors as well as Her-2/neu overexpression in all breast carcinomas seen at the Lagos State University Teaching Hospital, Ikeja, Nigeria, between April, 1, 2016, and September, 30, 2018. The total number of cases analyzed during the period under study was 107, comprising 105 women and 2 men with an age range of 26 to 88 years and a mean age of 52 ± 13 years. The tumors fell into histologic grade II (71.0%) and grade III (29.0%). They expressed ER, PR, and Her-2/neu positivity in 42.1%, 33.6%, and 30.8% of the cases, respectively. Triple-negative breast cancer was 35.5%. Male breast cancers presented as invasive ductal carcinoma and exhibit similar staining pattern as the female breast cancer. In conclusion, this study shows that breast carcinomas occurred predominantly in females of younger age and present with tumors, most of which were of high grade and exhibit triple negativity. This observation is relevant to any therapeutic decisions and management of these patients. Improvement in breast carcinoma screening programs so that the disease can be detected early is also advocated.

English

BACKGROUND Human epidermal growth factor receptor-2 HER2 / neu, is a trans membrane tyrosine kinase receptor of epidermal growth factor receptor (EGFR) family and is involved in the pathogenesis of urinary bladder cancer. In this study we attempted to evaluate the HER2 / neu expression in urothelial carcinoma of bladder and its association with tumour grading. METHODS This was a cross sectional study with a sample size of 75. Routine 4 micrometre thick sections of formalin fixed paraffin embedded tissue blocks stained with haematoxylin &amp; eosin were reviewed. Tumour grade was determined by using the World Health Organization (WHO) / International Society of Urological Pathologist criteria (ISUP). Immunohistochemistry was done by using HER2 / neu monoclonal antibody and its expression were observed. The membrane staining intensity and pattern were studied and scored. RESULTS In our study 75 cases of urothelial carcinoma were studied, of which 49 cases were papillary urothelial carcinoma low grade, 26 cases were papillary urothelial carcinoma high grade. Among these, 19 cases were infiltrating urothelial carcinoma. HER2 / neu positivity were observed in 27 (36 %) cases and overexpression in 8 (10 %) cases. Low grade urothelial carcinoma showed HER2 / neu positivity in 11 (22 %) cases and overexpression in 1 (2 %) case. High grade urothelial carcinoma showed HER2 / neu positivity in 16 (64 %) cases, among which 7 (28 %) cases showed overexpression. HER2 / neu positivity was seen in 13 (68 %) cases of infiltrating urothelial carcinoma with 4 (21 %) cases showing overexpression. A statistically significant difference in HER2 / neu expression was noted in high grade and invasive urothelial carcinoma compared to low grade and non-invasive urothelial carcinoma. CONCLUSIONS Urothelial carcinomas show overexpression of HER2 / neu and this over expression increases with increasing grade of tumour and muscle invasiveness. KEYWORDS Urothelial Carcinoma, HER2 / neu, Overexpression, Tumour Grade, Trastuzumab

Correlation of Serum HER-2/neu Levels with Clinico-Pathological Variables and Tissue Immunohistochemistry in Breast Carcinoma

Introduction: Serum levels of HER-2/neu protein is raised in primary as well as metastatic breast cancer and decreased serum HER-2/neu concentration in patients treated with HER- 2/neu inhibitors like trastuzumab is a good prognostic indicator in metastatic cases. Aims: To evaluate the concordance of serum HER-2/neu concentration with tissue HER-2/neu immunohistochemistry and determine its relationship with various prognostic indicators like age, size of tumour, lymph node status, grade, and stage of tumour. Materials and methods: The preoperative serum samples of 56 clinically and cytologically diagnosed cases of breast carcinoma were taken and postoperative mastectomy specimens were examined for the histologic type, lympho-vascular invasion, stage, and grade of the tumour. Immunohistochemical study of HER-2/neu xpression and HER-2/neu serum biochemistry was studied. Results: Age of the patients ranged from 25-75 years. Twenty-three cases (41.1%) were premenopausal while 33 cases (58.9%) postmenopausal. Forty-seven cases (83.9%) were of the infiltrating ductal carcinoma (NOS) type. Serum positivity for HER-2/neu was noted in 29 (51.8%) cases. Serum HER-2/neu levels showed a positive correlation with increase in tumour size, grade, stage of tumour and lymph node involvement. Serum HER-2/neu positivity was seen in 20 (68.9%) IHC positive patients and 9 (33.3%) IHC negative patients, with a statistically significant correlation (p=0.005). Conclusions: Serum HER-2/neu levels directly correlate with prognostic factors like tumour size, grade, stage of the tumour and lymph node metastasis and can be used as a complimentary tool to tissue HER-2/neu immunohistochemistry.

Study of the Relationship between MMP-2 and MMP-9 and Her2/neu Overexpression in Gastric Cancer: Clinico- Pathological Correlations.

Background:The relationship between the expressions of matrix metalloproteinases with clinico-pathological data on gastric cancer has been investigated in many countries, but this relationship remains unexplored in Iranian patients. Also, the correlation of the MMPs and the HER-2/neu proto-oncogene with other clinic-pathological variables has been evaluated for several other malignancies, but little effort has been made to shed light on the relationship with gastric cancer. Methods:We investigated MMP-2 and MMP-9 expression and HERE-2/neu overexpression in 48 gastric cancer patients referred to Afzalipour Hospital, associated with Kerman Medical University. Immunohistochemistry staining with rabbit polyclonal antibodies was used. Data statistical analysis was done by SPSS software (Version 20.0).Results:The mean age was 59, most of the patients were male (79.2%), and the average tumor size was larger than 5 centimeters in its greatest diameter. The majority of tumors were of the intestinal subtype and were located in the pyloric and antrum regions (43.8%). Invasion to muscularis properia was seen in 87.5% of the tumors (T3). MMP-2 and MMP-9 were highly expressed in 58.3% and 50% of cases, respectively, and Her-2/neu positivity was 10.4%. MMP-2, MMP-9 and HER-2 were found to have no relation with any clinicopathological parameters. Conclusion: According to the results of this study, MMP-2 and MMP-9 were highly expressed in gastric cancer, but there was no significant association with other clinicopathological variables.

Reducing PMA-induced COX-2 expression using a herbal formulation in MCF-7 breast cancer cells

Cyclooxygenase-2 (COX-2) is the inducible form of a group of enzymes that catalyze the conversion of arachidonic acid to prostaglandins. This isoform is often overexpressed in breast cancer cells. COX-2 overexpression correlates with an aggressive phenotype in breast cancer, including higher histological grade, larger tumor size, estrogen receptor (ER) negativity, and human epidermal growth factor receptor 2 (HER-2)/neu positivity. Another study, via molecular, animal, and human investigations, supported that COX-2 expression increases as cancer develops, getting progressively worse during the metastatic phase through the release of vascular endothelial growth factor (VEGF). Traditional medicine or herbal compounds have been gaining increasing popularity for alternative treatment for cancer alone and in conjunction with treatments. Green tea and turmeric are famous for their numerous beneficial effects on the body, including anti-oxidative, chemo-preventive, chemo-protective, anti-inflammatory properties. COX-2 expression was induced using phorbol-12-myristate-13-acetate (PMA). This study tested the effect of the herbal formulation HF1 (mainly composed of (-)-epigallocatechin-3-gallate (EGCG) and curcumin) on the COX-2 mRNA levels in the breast cancer cell line MCF-7. We hypothesized that PMA-induced overexpression of COX-2 in MCF7 cells would be eliminated after exposure to HF1. PMA increased COX-2 levels by 3-fold as compared to the untreated MCF-7 culture (no PMA, no HF1). However, when cells were treated with HF1 alongside PMA, we observed a 60% decrease in COX-2 levels.

Abstract B113: Unique hormone receptor signatures of inflammatory breast cancer in a cohort of Puerto Rican women

Abstract Inflammatory breast cancer (IBC) is an uncommon although highly lethal form of breast cancer. Existing IBC research focuses mainly on United States or European populations, limiting current knowledge of patient profiles in Hispanic populations. Given the unique genetic admixture that exists in PR, we are interested in characterizing IBC within this population to broaden understanding of this disease. We designed a retrospective study which was deemed exempt by the UCC-IRB. A sample of breast cancer patient charts were reviewed at Manatí Medical Center and Pavia Hospital. Of these, 18 eligible subjects with a new primary diagnosis of IBC between 2012-2019 were identified and data was collected from oncologist and pathologist reports. On review, 78% of patients were negative for HER-2/neu receptor overexpression and there was a difference, although not statistically significant (p=0.09) compared to other receptor status. This result differs from other studied populations which place HER-2/neu positivity in the range of 36-60% for IBC. Interestingly, 36.4% expressed the particular signature (ER+, PR+, HER2/neu-) and 36.4% presented as triple negative for tumor markers (ER-, PR-, HER-2/neu-) on pathology review. Our data suggests that within the context of the population studied, IBC is less likely to express HER-2/neu receptor compared to IBC in other populations, and we identified two specific signatures that comprise the majority of the cases studied. To improve patient outcomes for IBC it is critical to have foundational understanding of the disease characteristics and course within a diverse group of patients. This study aims to set such a foundation within the population of PR. With this knowledge, further treatments can be tailored to meet the needs of unique or minority populations such as this one. Citation Format: Zoe C Underill, Mayra Rivera, Michelle M Martinez. Unique hormone receptor signatures of inflammatory breast cancer in a cohort of Puerto Rican women [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B113.

Breast cancer: The Indian scenario.

e12567 Background: This study was undertaken to evaluate the clinic-pathological characteristics and outcome of patients with female breast cancer at I.R.C.H, AIIMS, New Delhi, one of the largest tertiary-care cancer center in India. Methods: This ambispective study included patients with breast cancer in females, registered at our institute from January 1st, 2014 to December 31st, 2018.We retrieved data from prospectively maintained clinical case records. Results: We included 997 patients with median age of 47.5 years (21–90) The TNM (AJCC-7th edition) stage distribution was stage I, 40 (4.01%); stage II, 326 (32.70%); stage III, 419 (42.02%); and stage IV, 212 (21.26%). The median tumour diameter was 5 cm. Infiltrating ductal carcinoma (96%) was the most common histologic subtype. Fifty eight percent of cases were positive for ER or/ and PR whereas 30.89% patients were HER2/neu positive. Triple negativity was found in 29.88 % of cases. Patients underwent breast conserving surgery in 28.2% of cases, 41.7% were received neo-adjuvant chemotherapy and 9.5 % of patients offered palliative chemotherapy. The pathological complete response was seen in 20.5% of cases. Loco-regional recurrence occurred in 2.8%, and 23.2% of patients developed distant metastases. The discordance of receptor was present in 20.5% for ER, 25.1% for PR, and 15 % for HER2/neu on re-biopsy at the time of relapse . Only 37.83% of the eligible patients received trastuzumab upfront. For non- metastatic group, the median time of relapse was 36 months, 3 year relapse free survival (RFS) was 73.5% and overall survival (OS) was 82.1% . Clinical stage(stage III), triple negativity and HER2 neu positivity were associated inferior RFS however pathological node involvement (HR 1.4, 95% CI 1.01–2.18, p = 0.01) and triple negativity (HR 1.9, 95% CI 1.36–2.90, p = 0.001) were associated with poor OS . For metastatic group, the median time of progression was 18 months and 3 year progression free survival (PFS) was 35% and OS was 20%. More than 2 sites of metastasis, upfront brain metastasis, triple negativity, and poor performance status (ECOG III/IV) were associated with inferior survival. Conclusions: This is one of the largest comprehensive data from a single center. Majority of our patients are younger in age, advance in stage, aggressive in biology and unaffordability of targeted therapy on eligible patients might lead to poor overall outcome. Triple negativity is found in around 30% of cases and associated with poor survival.

A study of her-2/ neu oncogene expression in benign and malignant ovarian tumors

Background: Ovarian cancers are very common worldwide with serous epithelial tumors being the most common. Her-2/neuprotoncogene encodes a protein belonging to the EGFR tyrosine kinase receptor family. Overexpression has been shown for poor prognosis in breast cancer. The study was done to find the association of ovarian tumors with Her-2/neu expression. Aim and objectives: To assess the clinicopathological profile of various ovarian tumors with special reference to age, histological type, grade, and stage of the tumor. To assess and compare the expression of Her-2/neu oncogene in benign and malignant ovarian tumors in relation to age, histological type, grade, and stage of the tumor. Method: The prospective study was done on 37 specimens received in the Department of Pathology; NIMS medical college from the period between 2015 to 2019. Results: All the benign and borderline tumors were negative for her-2/neu .48.6% of malignant tumors were her-2/neu positive. Conclusion: Her-2/neu positivity was seen in 24.3% of ovarian tumors. All the benign and borderline tumors were negative for her-2/neu. 48.6% of malignant tumors were her-2/neu positive.

HER-2/neu gene analysis on endoscopic biopsy samples and gastric resection materials in gastric carcinomas

Objective ― HER-2/neu assay in gastric cancers is routinely evaluated by immunohistochemistry and fluorescent in situ hybridization methods because the monoclonal antibody trastuzumab developed against HER-2/neu give rise to significant improving on the survival. In the HER-2/neu evaluation, some problems related to the sampling process, analysis method, tumor biology and heterogeinity are encountered. Our aim in the present study was to analyze these evaluation problems on endoscopic biopsy samples and resection materials of our cases with gastric carcinoma. Material and Methods ― The study included 109 gastric cancer cases. The analyses were realized on the resection materials of the 109 cases and the endoscopic mucosa biopsies of 43 out of these 109 cases. Immunohistochemistry was applied on mucosa biopsies and, tumor sections of resections, while fluorescent in situ hybridization was performed on tumor sections of resections (21 cases). The assays results were compared with each other and clinicopathological parameters. Results ― Our rate of HER-2/neu positivity (IHC3+ and IHC2+/FISH+ cases) was 6.42%. The compatibility rate between the rates of overexpression and amplification in resections was 90.5% while the compatibility ratio between the overexpression rates of mucosa samples and resections was 95.4%. The false negativity rate on mucosa biopsies was detected as 4.65%. HER-2/neu status was not correlated with unfavorable clinicopatological features. Conclusion ― Our gene positivity rate was near the lower limit of the range reported in the literature. Our compatibility rate between the results of immunohistochemistry and fluorescent in situ hybridization was over 90%. However our false negativity rate in mucosa biopsy analysis was low according to the literature. In order to preclude false negativity arising from tumor heterogeinity, we think that immunohistochemistry should be applied on the whole section.

Male Breast Cancer—an Indian Multicenter Series of 106 Cases

Male breast cancer (MBC) accounts for < 1% of all breast cancers. The available data on male breast cancer is mainly retrospective institution-based studies. Due to the scarcity of the disease, randomized controlled trials have not been feasible. Conducting a multicenter study is the next best option to assess the effectiveness of the treatment which is currently followed as per the guidelines on female breast cancer (FBC). Under the aegis of Delhi Breast Oncology Group (DBOG), data of 106 MBC patients was collected from 11 leading hospitals of Delhi and analyzed from January 2010 to April 2017. The age of the patients ranged from 35 to 82 years with a median of 59 years. The commonest presentation was a lump in the breast (98%). There was a delay in presentation of 1–6 months in the majority (86%) of cases. of the total number of patients, 51% had Stage II, 25% Stage III, 18% Stage I, 4% Stage 0, and 2% Stage IV breast cancer at the time of presentation. Infiltrating ductal carcinoma was the commonest histopathological finding. IHC receptor studies revealed ER positivity in 81% and PR positivity in 76%. HER2 neu positivity was seen in 25% of cases. Modified radical mastectomy was the commonest (92%) surgical procedure. Of the total number of cases, 18% received neoadjuvant chemotherapy, 35% received adjuvant chemotherapy, 32% underwent radiotherapy, and 74% received hormonal therapy. The 5-year cumulative disease-free survival was 60.7%. MBC is rare and unique. There are differences from FBC with respect to time of presentation, aggressiveness, histopathology, IHC markers, and response to treatment with a poorer outcome. Multicentric prospective studies are recommended for future research.

Association of Her-2 Expression and Clinicopathological Parameters in Colorectal Carcinoma in Indian Population.

BACKGROUND:Human epidermal growth factor receptor 2 (HER-2) is an oncogenic gene and a well-established therapeutic target in several cancers including breast and ovary.AIM:The present study aimed to compare HER-2 expression status with histological grades as well as Clinicopathological parameters including age, bleeding per rectum, pain/burning sensation in defecation and exercise.METHODS:Her-2 status was assessed by immunohistochemistry (IHC).RESULTS:Results of the study shows that 40.96% patients were Her-2 positive for expression and a statistically significant difference (p-value = 0.004) was observed in histological grades where most of the cases were of grade II. We also observed a significant difference in histological grades with gender (p-value = 0.04), as well as in both the age groups ≤ 55 years and > 55 years (p-value = < 0.0001). Patients with the bleeding rectum and pain/burning sensation in defecation had grade II/III tumours (93.4%, 88.7%) respectively. A significant association was observed between bleeding per rectum and pain/burning sensation in defecation. About 95% of patients with pain/burning sensation in defecation had bleeding per rectum.CONCLUSION:To conclude, Her-2 can be a potential prognostic marker in CRC. The role of age, tumour grade and bleeding per rectum/burning sensation in defecation are of significant worth. Thus, CRC cases of high grades can be screened for HER-2/neu positivity so that they can be subjected to mAb-based individualised therapy.

M-bioscore: proposing a new statistical model for prognostic factors in metastatic breast cancer patients.

The current study aims to propose and internally validate 'M-bioscore', which is a model to help predict the outcomes of untreated metastatic breast cancer patients. Surveillance, epidemiology and end results (SEER) database (2010-2013) was accessed. Patients were divided into two groups: a training set and a validation set. Through a Cox proportional model, multivariate analysis for potential prognostic factors was performed. M-bioscore was calculated for all patients. Survival analyses were conducted through Kaplan-Meier analysis/log-rank testing. A total of 6655 metastatic breast cancer patients were analyzed. In the training set, the following factors were linked to better cancer-specific survival in multivariate analysis: estrogen receptor positivity, isolated distant nodal metastases, progesterone receptor positivity, lower nuclear grade and HER2 neu positivity (p <0.01). Cancer-specific survival was then assessed according to M-bioscore. Adjusted Cox regression cause-specific hazard (using breast cancer death as the event of interest) was evaluated in the validation cohort. Pairwise hazard ratio comparisons between different scores were significant (p<0.05) except for the comparison between score 6 and 7. C-index for the validation cohort was 0.665 (Standard error (SE): 0.010; 95% CI: 0.646- 0.685). M-bioscore can predict the outcomes of untreated metastatic breast cancer patients. Validation of external datasets is needed.

Clinico-pathological characteristics and treatment outcome in invasive lobular carcinoma of the breast: An Indian experience.

Invasive lobular carcinoma (ILC) is the second most common histologic subtype of breast cancer and accounts for 10%-15% of all breast cancers in the west. There is a scarcity of data on ILC from the Indian subcontinent. This report intends to present the patterns of care, survival outcomes, and prognostic factors of ILC treated in a tertiary care institute. This retrospective analysis included consecutive patients diagnosed with ILC and registered at our Institute between 2009 and 2016. We included 97 patients with a median age of 53 years (range 28-80). American Joint Committee on Cancer (7th edition) stage distribution was stage I-8.24%, stage II-45.36%, stage III- 34.10%, and stage IV-12.30%. Bilateral breast cancer was seen in 8 cases. Estrogen receptor, progesterone receptor, and HER 2/neu positivity was 90%, 85%, and 9%, respectively. Triple-negative breast cancer constituted 5% of cases. Twenty-nine events were recorded (systemic and locoregional relapse) with a median follow-up of 3.5 years. Three years relapse-free survival (RFS) and overall survival were 80% and 60%, respectively. Bones were the most common site of metastasis. Age <45 years [HR-1.4 (0.8-2.1), P < 0.001] and advanced clinical tumor stage [T4, HR-2.1 (1.1-3.8), P = 0.001] were associated with poor RFS. ILC constituted 2.5% of breast cancer cases at our institute. Triple negativity and HER-2/neu positivity were seen in 9% and 5% of cases, respectively. Age <45 years and advanced clinical tumor stage were associated with poor RFS.