Radical Mastectomy Specimens Research Articles

Correlation of weight and volume of modified radical mastectomy specimen with ptosis of breast in patients of breast cancer

BackgroundPreoperative assessment of breast features is indispensable for both cosmetic and reconstructive breast surgical procedures. In this study we aim to investigate the effect of breast ptosis on breast volume estimation by various methods. MethodsFifty patients of breast cancer planned for modified radical mastectomy were taken up. Preoperatively breast anthropometric measurement taken, grade of ptosis was noted and breast volume was calculated by anthropometry and mammography and intraopratively mastectomy specimen weight and volume was recorded. Breast volume calculated by mammography and anthropometry compared with mastectomy specimen volume and weight and correlation with ptosis was statistically analyzed. ResultsMastectomy specimen volume showed best agreement with mastectomy specimen weight (r ​= ​.993, <.001), followed by mammographic method (r ​= ​.985, P ​< ​.001), anthropometry by breast circumference in supine method (r ​= ​.982, P ​< ​.001), anthropometry by breast circumference in upright method (r ​= ​.979, P ​< ​.001) and anthropometry by breast radius and mammary projection method (r ​= ​.969, P ​< ​.001). ConclusionMammography is simple, cost effective and most accurate method for breast volume estimation followed by anthropometric breast volume calculation. As size of breast and grade of breast ptosis increases the accuracy of all methods of breast volume estimation decreases.

Immunohistochemical expression of CD44 in invasive breast carcinoma

Background: In India, breast cancer forms the most common malignancy, accounting for 28.2% of all female cancers. Breast cancer consists of phenotypically diverse group of diseases. Due to different relapse abilities, doubling times, and different infiltrative capacities, it is important to identify potential biomarkers that could be used to screen high-risk patient and predict breast cancer prognosis in conjunction with classical pathological parameters. Aims and Objectives: The present study was conducted to evaluate immunohistochemical expression of CD44 in breast carcinoma and to correlate CD44 expression with other clinicopathological parameters and molecular classification of carcinoma breast. Materials and Methods: The present study was a prospective descriptive study conducted on 100 cases of carcinoma breast diagnosed on modified radical mastectomy specimens that were submitted to the Department of Pathology, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana, over the period of 2 years. Results: Out of 100, 64 cases (64%) were CD44 positive. Out of these 64 cases, 9 (9%) cases were 1+, 34 (34%) cases were 2+, and 21 (21%) cases showed 3+ positive expression of CD44 in tumor cells. Loss of CD44 expression was seen in 36 (36%) cases. A statistically significant association of CD44 was seen with multifocality of the tumor, negative estrogen receptor/progesterone receptor (ER/PR) expression, and molecular subtypes. No statistically significant association of CD44 was seen with age, side of tumor, lymph node metastasis, lymphovascular invasion, ductal carcinoma in situ and Ki67, and HER2neu expression. Conclusion: A high CD44 expression in breast carcinoma correlates with aggressive tumor characteristics such as multifocality, negative ER/PR expression, and belonging to the basal subtype which is associated with poor prognosis. Conversely, low CD44 expression is linked to Luminal A and Luminal B subtypes which have good prognosis. These indicate the role of CD44 as a prognostic biomarker in the carcinoma breast.

Carcinoma Breast Presenting with Concurrent Extensive Lymph Nodal Sarcoidosis

Sarcoidosis is a systemic disease characterized by noncaseating granulomas involving any organ. Concurrent carcinoma breast with sarcoidosis is a rare occurrence. A 51-year-old female presented with right breast lump and was diagnosed with infiltrating ductal carcinoma with lymph nodal (LN) metastases (estrogen receptor, progesterone receptor positive, and HER2neu negative). Baseline fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan revealed breast mass with multiple LNs. Biopsy of iliac and internal mammary LNs indicated granulomatous lymphadenitis. A possible diagnosis of sarcoidosis was considered. End of chemotherapy (4 EC, 12 paclitaxel), FDG PET/CT revealed a complete metabolic response in breast mass. Most lymph nodes were resolved. Modified radical mastectomy specimen was negative for breast malignancy with granulomatous lymphadenitis in LNs.

To study the utility of COX-2 as immunohistochemical prognostic marker in comparison to various histopathological parameters and TNM staging in breast carcinoma: an observational, cross-sectional study protocol.

Breast cancer is the most prevalent cancer among women worldwide and is a well-known cause for cancer mortality in females. COX-2 (cyclooxygenase) plays a vital role in development of some human cancers such as lung, colon and breast. It is a potent enzyme that is important for the conversion of arachidonic acid into prostaglandins. These prostaglandins mediate cellular proliferation, apoptosis and angiogenesis which contributes to carcinogenesis. Overexpression of COX-2 has been detected in several malignancies including breast cancer. COX-2 overexpression is regarded as a poor prognostic marker of breast cancer.The present study will aim to study the immunohistochemical expression of COX-2 in breast cancer and compare it with known histopathological parameters thus assessing its prognostic value. This will be an observational study conducted in the Department of Pathology, JNMC, Wardha (Sawangi). Radical mastectomy specimens will be studied for COX-2 expression by immunohistochemistry in patients diagnosed with breast carcinoma. COX-2 expression will be quantified as immunohistochemical score and results will be correlated with various histopathological parameters. The expected result of our study will suggest an association of COX-2 expression to the factors associated with poor prognosis in breast carcinoma. A positive correlation is expected between larger tumor size, positive lymph node status, higher T stage and N stage and lymphovascular invasion. Conclusions will be drawn from the obtained results of the immunohistochemical study by using COX-2- for detection of overexpression of COX-2 when evaluated with TNM staging, histological grading and molecular types of breast cancer.

To study the utility of COX-2 as immunohistochemical prognostic marker in comparison to various histopathological parameters and TNM staging in breast carcinoma: an observational, cross-sectional study protocol

Background: Breast cancer is the most prevalent cancer among women worldwide and is a well-known cause for cancer mortality in females. COX-2 (cyclooxygenase) plays a vital role in development of some human cancers such as lung, colon and breast. It is a potent enzyme that is important for the conversion of arachidonic acid into prostaglandins. These prostaglandins mediate cellular proliferation, apoptosis and angiogenesis which contributes to carcinogenesis. Overexpression of COX-2 has been detected in several malignancies including breast cancer. COX-2 overexpression is regarded as a poor prognostic marker of breast cancer. The present study will aim to study the immunohistochemical expression of COX-2 in breast cancer and compare it with known histopathological parameters thus assessing its prognostic value. Methods: This will be an observational study conducted in the Department of Pathology, JNMC, Wardha (Sawangi). Radical mastectomy specimens will be studied for COX-2 expression by immunohistochemistry in patients diagnosed with breast carcinoma. COX-2 expression will be quantified as immunohistochemical score and results will be correlated with various histopathological parameters. Results: The expected result of our study will suggest an association of COX-2 expression to the factors associated with poor prognosis in breast carcinoma. A positive correlation is expected between larger tumor size, positive lymph node status, higher T stage and N stage and lymphovascular invasion. Conclusions: Conclusions will be drawn from the obtained results of the immunohistochemical study by using COX-2- for detection of overexpression of COX-2 when evaluated with TNM staging, histological grading and molecular types of breast cancer.

Pathological response of different molecular subtypes of locally advanced breast carcinoma to neoadjuvant chemotherapy

Background: This study was done on modified radical mastectomy (MRM) specimens of patients with locally advanced breast carcinoma (LABC) who were categorized into molecular subgroups based on Immunohistochemistry and underwent neoadjuvant chemotherapy (NACT). The purpose of the study was to look for the pathological response of the tumor to the NACT. The molecular subtypes include Luminal A, Luminal B, Human epidermal growth factor receptor 2 (HER2) enriched, and triple negative. For HER2 enriched subtype, trastuzumab was also given along with the chemotherapy regimen. Aims and Objectives: The primary objective of this study is to find out the pathological complete response (pCR) in various molecular subgroups of breast carcinoma following NACT. The secondary objective is to describe the cellular changes in tumor tissue following NACT. Materials and Methods: This is a descriptive study done on MRM specimens of patients with LABC received in histopathology lab of Government Medical College, Kottayam to look for the pCR of the tumor following NACT. Gross examination and histopathology study of the specimen including axillary lymph nodes were done. The trucut biopsies of these cases with immunohistochemistry study were reviewed for confirming the grade and molecular subtype. pCR was assessed based on Chevallier system. Results: Of the 131 MRM specimens studied, overall pathologic complete response rate was 24.4% and the pathologic complete response rate in Luminal A subtype, Luminal B subtype, HER2 enriched tumors, triple negative tumors were 23.6%, 24%, 33%, and 20%, respectively. Conclusion: 33% of HER2 enriched subtype showed a pCR, i.e., no residual foci of neoplasm seen in the MRM specimens following NACT. Following NACT, change in tumor cellularity, changes in the morphology of neoplastic cells, changes in the surrounding breast tissue, and a change in grade of tumor were also noticed.

Comparison of 10% Buffered Formalin Fixation and Carnoy's Solution in Revealing the Axillary Lymph Node Counts in Modified Radical Mastectomy Specimens

Comparison of 10% Buffered Formalin Fixation and Carnoy's Solution in Revealing the Axillary Lymph Node Counts in Modified Radical Mastectomy Specimens

Correlation of proliferative index with various clinicopathologic prognostic parameters in breast carcinoma

Introduction: Breast cancer (BC) is the most common cancer and the second most common cause of death in women. Prognostic factors are essential in BC diagnosis as they allow the identification of high-risk patients, for whom, an adjuvant therapy can improve prognosis. Interest in Ki-67 has recently increased as Ki-67 is a potential marker for predicting the responsiveness to chemotherapy. Materials and Methods: The study was conducted on 75 consecutive cases of primary breast carcinoma undergoing radical or modified radical mastectomy specimen. Histopathological diagnosis was established on routine hematoxylin and eosin stain and various histologic prognostic parameters including histologic type, histologic grade, and lymph node metastases were assessed. All biopsy proven carcinoma breast were included in this study. Results: Among presenting compliant, 47 (62.66%) had lump in right breast and 28 (37.33%) had lump in left breast. Most patients in the study population presented with a lump of duration 3-6 months (54.6%). Out of 75 participants, 41 (62.66%) participants were diagnosed with carcinoma right beast and 28 (37.33%) with carcinoma left breast. On staging the disease among the study population, most of them diagnosed with breast cancer were of stage IIIB (48%) followed by IIA (25.33%).

Cytological Grading of Breast Carcinomas and Its Prognostic Implications.

IntroductionDetermining the histological grade of breast carcinomas before mastectomy is necessary to decide about neoadjuvant chemotherapy. Core needle biopsies used for this purpose often under-grade the tumour. The grade obtained from fine needle aspiration cytology samples will help in such situations and whenever biopsy is not done, as in a resource-poor setup. Many studies are being done to find out the cytological grading system that correlates well with histological grading.MethodsThis study was done between 2016 and 2019 including the cases in which both modified radical mastectomy and fine needle aspiration of the tumour had been done. Robinson’s cytological grading was done in Papanicolaou and haematoxylin & eosin (H&E) stained cytology smears and correlated with modified Bloom-Richardson histologic grading done in modified radical mastectomy specimens. We also studied the prognostic significance of Robinson’s method by studying the association between cytological grade and lymph node metastasis.ResultsSixty cases were studied. The two methods had the same grade in 49 (81.7%) cases. They showed a significant positive correlation (Spearman correlation coefficient 0.848, p-0.0001), significant association (Chi-square test, p-0.0001), and substantial agreement (kappa value 0.72). Multiple regression analysis showed chromatin score and nucleoli score as the most influential parameters. Lymph node metastasis showed significant association with cytological grade (p-0.0003), cell dissociation score (p-0.0001), nucleoli score (p-0.01), and chromatin score (p-0.04).ConclusionRobinson’s cytological grading is a simple, reliable adjunct/alternative to core needle biopsies for grading breast carcinomas before mastectomy. Hence, it can be made a part of routine cytology reporting of breast carcinomas. Further long-term studies will help in confirming its prognostic significance.

A Study of Molecular Subtypes of Carcinoma Breast by Immunohistochemistry at Tertiary Care Center, Jaipur

Introduction: Breast cancer is one of the most common malignant tumors and one of the leading causes of cancer related death amongst females worldwide. The clinical significance of molecular classification of carcinoma breast remains to be established. Molecular subtyping using immunohistochemistry can provide additional prognostic and predictive information. Aim and objectives: To identify morphological variants of carcinoma breast and to determine various proportions of molecular subtypes of carcinoma breast by immunohistochemistry. Materials and Methods: A descriptive type of observational study was done at SMS Medical College, Jaipur. 65 Modified Radical Mastectomy specimens received in the department were included in the study. The surgical specimens were then evaluated histopathologically and immunohistochemically for ER, PR, HER2/neu, and Ki67 markers. Results: Out of 65 breast carcinoma cases the most common histological type encountered in our study was Invasive ductal carcinoma of no special type (NST) (83.09%) followed by medullary carcinoma (4.63%) and invasive lobular carcinoma (3.09%) and a single case each of tubular, cribriform, metaplastic, lymphoepithelioma like carcinoma, carcinoma with apocrine differentiation and oncocytic carcinoma. The cases were further classified into molecular subtypes using protein expression patterns in IHC. The proportion of tumors found were Luminal A (32.31%), Luminal B (18.46%), HER2/neu overexpressed (13.84%), and Triple-negative (35.39%). Conclusion: The most common molecular subtype found in our study was Triple negative. The use of IHC markers in the clinical setting could determine the prognosis and benefit the patients with targeted therapies.&#x0D;

Histopathological Grading and Staging of Invasive Ductal Carcinoma in Modified Radical Mastectomy Specimens

Background: Breast carcinoma is the most common malignancy in females associated with high mortality rate. Objective: The purpose of present study was to describe the histological grade and histopathological stage of invasive ductal carcinoma of breast among female patients and to determine the association of tumor size and histological grade withnodal metastasis. Methods: This is an analytical cross sectional study, conducted in the Department of Pathology Fatima Jinnah Medical University Lahore, Pakistan from September, 2019 till February, 2020. Female patients of all age groups who were diagnosedwith invasive ductal carcinoma and underwent modified radical mastectomy were included in the study. Tissue processed and Hematoxylin and Eosin staining was performed. All the sections were examined under the light microscope by myself and two other consultant pathologists independently. Histological grading of invasive ductal carcinoma was done by following Modified Scarff Bloom Richardson grading system and histopathological staging was done according to CAP protocols. Results: Total of 60 female patients diagnosed with invasive ductal carcinoma were included in the present study. Mean age of the patient calculated was 48.17± 13.12 years with age range from 26 to 90 years. Size of the tumor ranged from 1cm to 10cm. On microscopy, histological grade III was the most frequent grade (36, 60%). Out of total 60 cases n=43(71.6%) were diagnosed with regional lymph node metastasis and T2N1Mx( 17,38.3%) was the most frequent stage of the tumor. Statistically no significant association of tumor size and histological grade was observed with regional lymph node metastasis (p &gt;0.05).

Aggressiveness of Breast Carcinoma in Young Pre-Menopausal Patients

Background: Breast cancer is the most commonly diagnosed malignancy in female population. Aim: To determine and compare the frequency of aggressiveness of breast cancer in pre and post-menopausal patients. Study design: Cross sectional study Place and duration of Study: Department of Histopathology, K.E. Medical University Lahore from 1st January 2016 to 31st December 2018. Methodology: One hundred and fifty female patients diagnosed with breast cancer to assess the aggressiveness of breast cancer in young - premenopausal patients. Post-Surgical Modified Radical Mastectomy specimens were submitted and evaluated for grade, stage, involved lymph nodes, tumor size and metastasis. Results: Sixty four percent of the tumors were left sided and the invasive ductal carcinoma was the most dominant histologic type (96%). Ninety two patients were premenopausal while 58 were post-menopausal. Nodal positivity in patients less than 40 years was more pronounced (74.2% versus 56.8%, p=0.029). Conclusion: Young premenopausal patients represent high risk group for advanced breast cancer. Key words: Breast Cancer, Young, Premenopausal, Post-menopausal, Invasive Ductal Carcinoma

Evaluation of Immunohistochemical Expression of Topoisomerase II Alpha Protein in Patients with Breast Cancer and Its Correlation with Different Prognostic Factors

Background: There are indications to support the knowledge about the prognosis of breast cancer. One of these markers is regarded as a prognostic factor and related to the proliferation rate. Topoisomerase IIα (TOP2A), encoded by the TOP2A gene, is a molecular target for anthracycline therapy. Aims: The aim of this article is to establish any association of the status of topoisomerase IIa immunohistochemistry with different prognostic clinicopathological and molecular parameters in breast cancer. Settings and Design: A cross-sectional retrospective study was carried out in the Department of Pathology and Forensic Medicine, Faculty of Medicine, Babylon University, during the period from January 2020 through December 2020. Materials and Methods: Fifty cases with invasive breast carcinoma have been obtained from surgical modified radical mastectomy specimens from the Laboratory of Histopathology in Al-Kafeel Specialized Hospital, Karbala for the last 3 years (2017–2019). Different clinicopathological variables were estimated. The expression of TOP2A was stained by using the PathnSitu PolyExcel Detection System of Immunostaining. Statistical Analysis Used: Immunostaining with TOP2A expression used a cut-off value of 10%. The results were considered statistically significant if the P-value was ≤ 0.05. Results: Fifty cases of TOP2A overexpression were classified as follows: 28 cases (56%) had 3+ expression, 4 cases (8%) with 2+ expression, and 4 cases (8%) with 1+ expression, whereas 14 cases had no expression of TOP2A (28%). TOP2A overexpression was shown to be associated with a higher grade (P = 0.023) and molecular subtypes (P = 0.057), but not with other clinicopathological parameters (age of patients, type of histology, number of lymph nodes involved, tumor size). Conclusion: According to these results, TOP2A plays a major role in the aggressive nature of tumors. This may support the suggestion to be used as a prognosis marker.

THE RELEVANCE AND IMPORTANCE OF TUMOR INFILTRATING LYMPHOCYTES (TILS) IN BREAST CANCER

Tumor infiltrating lymphocytes (TILs) were evaluated in many cancers like ovarian tumors, endometrial tumors, colon cancer and melanoma. Now there is increasing trend in evaluating TILs in breast cancer. Tumor infiltrating lymphocytes gives the patients immune response to the tumor. 100 cases of Modified radical mastectomy specimen were chosen from surgical pathology records. The representative formalin fixed paraffin embedded tissue samples were collected. Detailed history regarding Patients age, sex, side of the breast involved , Grade and neoadjuvant chemotherapy were assessed for 100 cases. Tumor Infiltrating Lymphocytes are evaluated with Immuno HistoChemistry CD45 and CD3 for 100 cases , in which 93% cases were Infiltrating Ductal carcinoma-NOS cases and 07 % cases are of special types like Mucinous, Metaplastic, Apocrine, and Medullary carcinoma. Results: In our study, Highest incidence of breast carcinoma occur in the age group of 41-50 years. Infiltrating Ductal Carcinoma NOS is the most common primary malignant neoplasm of breast constituting 93% of cases. Most of the malignant tumors are left sided. Forty seven percent of cancers are presented in the size range of 2-5cms. Majority of the tumors are of Grade II accounting for 63.5% of all cases. TILs were evaluated with three variables 0- 10 % 20- 40 % and 50- 90 %.Younger the age, more the TILs. Neo adjuvant chemotherapy had significant correlation with TILs (P= 0.05).

COMPARISON OF CLINICOPATHOLOGICAL PARAMETERS WITH HISTOLOGICAL AND MOLECULAR CLASSIFICATION OF BREAST CANCERS

BACKGROUND: This is a retrospective study of 60 cases, to detect the expression of ER, PR, HER2neu, CK5/6 and Ki67 proliferation index in breast carcinomas by immunohistochemical method and to determine the newer molecular classication. Few patients have recurrence inspite of being diagnosed under the category of low risk and few do well in the high risk group which can be attributed to the molecular level differentiation. AIM: The aim of this study is to categorize the patients under molecular classication, and to compare the clinicopathological parameters with it and to denote the signicance of targeted therapy. MATERIALS AND METHODS: A retrospective study of detecting the expression of the above said markers in modied radical mastectomy specimens received at a tertiary care centre during the period from January 2015 to June 2018. A total of 60 cases which included 30 of IDC NST and 30 cases of special variants were selected for immunohistochemical analysis. RESULTS: Out of the 60 cases studied, the most common was found to be the luminal A type comprising 37% and the least common was the luminal B and hybrid types each comprising 8%. The most common grade for HER2 was Grade III (50%). The association of histological grade with the molecular classication was statistically signicant with the p value of 0.01. Basal type (56%) had the highest incidence of N3 stage. ER, PR, HER2 neu, CK5/6 expression and proliferation index with Ki67 had a statistically signicant association with the molecular classication. High proliferation index (&gt;14%) with Ki67 was noted in Luminal B, Basal and Hybrid types. 78% of the total 60 cases were alive and healthy. One death was reported in HER2, Hybrid and Basal types. The negative kappa value obtained while studying the agreement between the histopathological and molecular classication, indicates that the agreement is worse than chance and hence the importance of molecular classication is substantiated for the targeted therapy.

A CROSS SECTIONAL STUDY OF BREAST CANCER HISTOMORPHOLOGY AND ITS CORRELATION WITH ER/PR, HER 2NEU AND KI-67 EXPRESSION IN A TERTIARY CARE HOSPITAL AT KANPUR

BACKGROUND Breast carcinoma is the most well-known malignancy in women. Different predictive and prognostic factors, for example, estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor receptor (Her2neu), and Ki67 could inuence breast carcinoma behaviour, yet to date no authoritative connection has been set up among them and breast carcinoma subtypes. In this way present study was done to determine the interrelationships of these predictive and prognostic factors for breast carcinoma. METHODS In this cross sectional study, a total of 50 lumpectomy, modied radical mastectomy specimens of diagnosed carcinoma breast were included in this study. The histopathological grading of the breast carcinoma was performed by Nottingham modication of the Bloom Richardson grading system. All the cases went through immunohistochemistry for ER, PR, Her2neu and Ki67 expression. Association of ER, PR, Her2neu and Ki67 with different histomorphology was established. RESULTS The ER positivity was signicantly lower in tumors &gt;5 cm size whereas Ki67was signicantly increased with increased tumor size. The ER positivity was signicantly lower in high grade tumors as compared to low grade tumors. The positive ER, PR, Her2neu and Ki67 were comparable in between premenopausal and post-menopausal age groups CONCLUSION The present study concludes that ER, PR show inverse while ki67 showed a direct relationship with the tumor grade. Correlation of histomorphology of breast tumor and Her2neu status could not be established.

Expression of vimentin in breast carcinoma and its correlation with histopathological parameters

Background and Objectives: Despite various treatment and diagnostic options, Breast cancer remains one of the top cancer in women both in developed and the developing world. In such a scenario, Immunohistochemistry plays an important role in pathology of breast disease which contributes for solving diagnostic problems and for determining prognosis and response to therapy. There is growing list of IHC markers available, the present study highlights the importance of vimentin a mesenchymal marker in breast carcinoma cases. Objectives of the Study: 1) To assess the expression of vimentin in various types of breast carcinomas. 2) To find out the correlation between expression of vimentin and prognostic markers such as tumor size, tumor grade and lymph node status. Materials and Methods: The study included 50 cases of modified radical mastectomy specimens received in the Department of Pathology, during December 2017 to May 2019. After collecting the history, the specimens were examined, fixed in 10% formalin and sections were studied by hematoxylin and eosin and immunohistochemically. Results: In the present study majority of the patients were in the age group of Keywords: Breast carcinoma, Lymph node status, Tumor size, Tumor grade, Vimentin.

Breast adenomyoepithelioma with ductal carcinoma in situ: An unusual entity

Adenomyoepithelioma is a rare biphasic tumor characterized by the proliferation of inner glandular epithelial cells and outer myoepithelial cells. These tumors have a low-grade potential for local recurrence and malignant transformation. Here, we present the case of a 51-year-old female who presented with a right breast lump for 1 month. Mammography was suggestive of BIRADS 4/5 for the right breast while BIRADS 1 for the left breast. FNAC was reported as benign breast disease, whereas, trucut biopsy of the same lesion was suggestive of invasive ductal carcinoma with ductal carcinoma in situ (DCIS). A final diagnosis of adenomyoepithelioma with DCIS component was confirmed on the right modified radical mastectomy. We, hereby, describe an extremely unusual case of biphasic breast adenomyoepithelioma that depicted benign features on FNAC and features of an invasive ductal carcinoma on trucut biopsy. Its distinct histomorphology with a characteristic epithelial-myoepithelial immunohistochemical profile on modified radical mastectomy specimen led to a definitive diagnosis of adenomyoepithelioma with DCIS.

Evaluation of p53 in breast cancer and its correlation with various histological prognostic factors

Carcinoma of the breast is the most common non-skin malignancy in women. The p53 gene is one of the most commonly mutated genes described in human neoplasia. Mutant p53 protein has greater stability and longer half time than the wild type protein that can be detected by Immunohistochemistry. This study was conducted to evaluate the expression of p53 in breast carcinoma and its correlation with various histological prognostic markers to determine its significance as a prognostic marker in breast cancer. The prospective study included 52 modified radical mastectomy specimens diagnosed as breast cancer in the Department of Pathology at SRMSIMS, Bareilly between November 2016 and April 2018. Routine H&amp;E staining and immunohistochemical analysis for ER, PR, Her2/neu and P53 was carried out in all the cases. Majority of the cases belonged to the age group 30-39 years and the most common cancer type was infiltrating ductal carcinoma. Significant correlation of p53 was observed with ER and PR expression, however no significant correlation could be found with tumor type, grade, size, type of margin, necrosis, stromal response, lymphovascular invasion, lymph node status and Her2/neu status.P53 was found to have a significant inverse correlation with ER and PR expression only. The results do not resolve whether detectable p53 protein expression represents a random product of dedifferentiation or an important feature of the malignant phenotype, playing a key role in tumor behavior.

Histomorphological evaluation of Breast carcinoma – A study of 15 cases

Purpose/Objective: Breast cancer occurs in any of the cells of the mammary gland and exhibits a wide scope of morphological features, different immunohistochemical profiles, and unique histopathological subtypes that have specific clinical course and outcome. This study was conducted to assess various histomorphological variants of breast carcinoma. Material and Methods: Total of fifteen cases of modified radical mastectomy specimens were prospectively assessed from January 2019 to June 2019 in pathology department of Dr B.R. Ambedkar Medical college and hospital, Bangalore. Observation: Out of 15 cases, Invasive ductal carcinoma NOS was most common variant accounting for 10 cases (66.66%) followed by 1 cases of Invasive Lobular Carcinoma breast, 1 case of Invasive micropapillary carcinoma, 1 case of Medullary carcinoma, 1 case of Metaplastic breast carcinoma. The histological grading of breast carcinoma was done on the basis of Elston – Ellis modification of Scarff - Bloom - Richardson grading system. We found that Grade 2 tumours were more common accounting to 9 cases (60%) followed by Grade 1 tumour (26.66%). Conclusion: This study emphasizes on the importance of assessment of histopathological variants of breast carcinoma in not only in establishing the final diagnosis, but also in predicting the prognosis by histological typing, staging and grading of breast carcinoma. Keywords: Breast carcinoma, MRM, Histomorphology, WHO, Staging, Grading.