Tertiary Care Cancer Center Research Articles

Severe enterocolitis with capecitabine (CAPE) is not a predictor of gastrointestinal (GI) toxicity with infusional 5-fluorouracil (5-FU)–based regimens: An institutional analysis.

89 Background: Enterocolitis is a potentially fatal toxicity of CAPE. The safety of infusional 5-FU-based regimens in patients developing severe enterocolitis with CAPE is not well established in the literature. Methods: After institutional review board approval, a database search identified patients who received infusional 5-FU-based regimens between January 2015 and July 2022 in a tertiary care cancer center after experiencing severe CAPE-induced enterocolitis, defined as the presence of grade 3 or higher diarrhea and features of enterocolitis on computed tomography (CT) scan. Data on patient characteristics, grade of CAPE-induced diarrhea, clinical course, details of 5-FU-based regimens administered after recovery, and outcomes were collected by retrospective electronic chart review. Results: Among the 791 patients treated with CAPE during the study period, 27 (3.4%) developed grade 3 or higher diarrhea, and 15 of these 27 patients (1.9%) had evidence of enterocolitis on CT scan. All patients were treated with supportive measures. All but 1 patient recovered fully; 1 patient died due to a condition unrelated to CAPE toxicity. After complete recovery, 7 patients aged 46 to 69 years (median, 68 years) received FOLFOX (oxaliplatin and infusional 5-FU). The time interval between recovery from CAPE-induced enterocolitis and the start of infusional 5-FU ranged from 4 to 20 weeks (median, 12 weeks), with 3 patients starting 5-FU within 4-5 weeks of recovery. Standard dose 5-FU (2400 mg/m2 over 46 hours) was given to 2 of the 7 patients; the remaining 5 patients received 50% to 80% of the standard dose at the beginning of treatment, but eventually tolerated the standard dose. All patients tolerated 5-FU infusion without experiencing any grade 2 or higher 5-FU induced GI toxicity. Conclusions: Most patients developing severe enterocolitis with CAPE recover fully with appropriate supportive measures. Infusional 5-FU-based regimens appear to be safe in this patient group. Severe CAPE-induced enterocolitis should not preclude the use of infusional 5-FU-based regimens, especially in curative-intent settings such as adjuvant therapy.

Impact of anterior commissure involvement on oncological outcomes after laser cordectomy in Early glottic cancers- 10 year retrospective analysis from a tertiary care cancer centre in India

Impact of anterior commissure involvement on oncological outcomes after laser cordectomy in Early glottic cancers- 10 year retrospective analysis from a tertiary care cancer centre in India

Retrospective audit of utility of MRI in breast imaging- high volume, single tertiary care cancer centre experience

Retrospective audit of utility of MRI in breast imaging- high volume, single tertiary care cancer centre experience

Pediatric Hodgkin’s lymphoma: experience from a tertiary cancer center in North East India

Background: Hodgkin’s lymphoma is a clonal malignant lymphoid proliferation, which originates from the germinal centers of B cells. This study was conducted to observe the socio-epidemiological profile of Hodgkin’s lymphoma in a tertiary cancer care centre from North East India. Methods: All patients from 0 to 18 years of age group with histopathologically proven diagnosis of HL, presenting to department of medical & pediatric oncology at Dr. Bhubaneswar Borooah cancer Institute during the period January 2012 to December 2019 were included in the study. Clinical parameters assessed included age, sex, locality, occupation, presenting symptoms, performance status, site of lymph node involvement, treatment modality, response to treatment, progression free survival and overall survival. Results: A total of 64 patients with histopathologically confirmed diagnosis of HL were registered in lymphoma joint clinic of BBCI from January 2012 to December 2019. The mean age was 12.68±4.71 years. Out of 64 patients, 54 (84.4%) belonged to rural areas and 10 patients (15.6%) to urban areas. Complete response was observed in 93.5% patient with limited risk disease, 73.24% with intermediate risk and 60% with advance stage. The overall survival and event free survival rates of 91% and 78.1%, respectively, were observed at 4 years. Conclusions: This study provides insight to incidence, demographic profile, overall response rates and survival pattern with other secondary objectives such as complete response rate, compliance rate and toxicity assessment among children with Hodgkin lymphoma belonging to Northeastern India.

Clinicopathological Profile of Non-small Cell Lung Cancer and the Changing Trends in Its Histopathology: Experience From a Tertiary Care Cancer Center in Kashmir, India.

Background The overall frequency and incidence of different cancers across the globe, including lung cancer, are marked by ethnic and geographical variations. Lung cancer is the most commonly diagnosed cancer worldwide that inflicts most of the cancer deaths. Non-small cell lung cancer (NSCLC) constitutes mostlung cancer cases. The aim of this study was to find the frequency and clinicopathological characteristics of NSCLC in high incidence zone of Kashmir, an ethnically and geographically distinct area in Northern India. Material and methods The study was conducted to evaluate the clinicopathological profile of NSCLC at a tertiary care cancer center,Sher-I-Kashmir Institute of Medical Sciences (SKIMS). The patients and case records were analyzed for clinical presentation and demographic features, smoking status, radiological features, histopathological type, and stage of their disease at presentation. Results The study included 1557 NSCLC patientsregistered over a period of seven years, i.e., 2008-2014. Most of the patients belonged to rural areas (70%).The median age of the whole cohort was 58.0 years (ranges 22-95 years), and the male-to-female ratio was 3.7:1 (male = 1231 and female = 326). Smokers comprised 77.39% of cases, and Hookah was the most common form of smoking (65.06%). The ratio of squamous cell carcinoma and adenocarcinoma was 3.7:1 (67.5% vs. 24.9%). Stage III and IV disease accounted for 93% of cases (30.6% and 62.7%, respectively). Squamous cell carcinoma histopathology was dominant in smokers (74.3%) compared to adenocarcinoma (19%), while squamous cell carcinoma and adenocarcinoma histopathology ran parallel in nonsmokers (45.1% and 44%, respectively). Most of the patients had an Eastern Cooperative Oncology Group (ECOG) performance status between 1 and 2 (79%). Conclusion We conclude Kashmir region is a very high-risk area for lung cancer, with NSCLC showing a high incidence. Most of our patients present in advanced stages, and the frequency of adenocarcinoma is showing an increasing trend over the years from 2008-2014.

A Comparative Analysis of Early T-Cell Precursor Lymphoblastic Leukemia/Lymphoma (ETP-ALL/LBL) and Non-ETP-ALL/LBL in a Tertiary Cancer Care Center Based in Western India.

Early T-cell precursor lymphoblastic leukemia (ETP-ALL) has a unique immunophenotype with very early T-cell differentiation. The current study summarises the distinct clinicopathological aspects of ETP-ALL and compares them with non-ETP-ALL. Twenty-nine ETP-ALL and 191 non-ETP-ALL cases were retrieved between 2018 and 2021. A P value was determined for each of the patient charaterisics (Table 1) to see for any significant relationship (P < 0.05) with ETP-ALL versus non-ETP-ALL. Kaplan-Meier log rank test was applied to look for any significant differences in OS for both the ALLs. ETP-ALL had an incidence of 12.6% out of total T-Acute lymphoblastic leukemia (T-ALL/LBL) in the past 3-years. Compared to non-ETP-ALL, ETP-ALL cases were associated with lower median age and male-to-female ratio. There was no statistically significant difference in the complete remission rate between both the subtypes. ETP-ALL was seen to be associated with high induction failure and relapse rate compared to non-ETP-ALL. To summarise, since the 2-year OS was poor compared to western research (for both ALLs), an intensive chemo-regimen should be implemented in the current situation. Some unusual markers were observed on flow-cytometry (ETP-ALL), which can be useful for MRD quantification, prognosis, and further trials for newer targeted therapies.

Evaluating the Psychosocial Determinants of Patients and Caregivers Seeking Treatment at a Tertiary Cancer Care Center: A Clinical Study

ABSTRACT Objective: This clinical study aimed to evaluate the psychosocial determinants influencing patients and caregivers seeking treatment at a tertiary cancer care center. Methods: The study included 175 patients or caregivers (86 males and 88 females) who visited the cancer hospital for checkups or treatment. Data were collected using self-designed questionnaires. The questionnaire assessed psychological and psychosocial issues, including anxiety, sleep, appetite, pain, fatigue, distress, depression, financial issues, family issues, social support, occupational issues, sexual issues, patient satisfaction, mood and thought, and concerns about the future. Statistical analyses, such as independent t-tests, were conducted to compare the differences between demographic factors and psychological and psychosocial issues. Results: The findings revealed that males scored higher on psychological issues, while females scored higher on psychosocial issues. Caregivers reported higher scores on both psychological and psychosocial issues compared to patients. Married patients exhibited higher scores on anxiety, sleep, and appetite compared to unmarried patients. Moreover, individuals with a family history of cancer scored higher on psychological issues, while those without a family history of cancer scored higher on psychosocial issues. Conclusion: The study highlights the significance of addressing psychosocial determinants when patients or their caregivers visit a tertiary cancer care center. Understanding and addressing psychological and psychosocial factors can contribute to better support and treatment for cancer patients and their caregivers.

ALK-positive Large B-cell Lymphoma: A Clinicopathologic Retrospective Descriptive Study from a Tertiary Care Cancer Centre in India

Introduction: Anaplastic Lymphoma Kinase (ALK) positive Large B-Cell Lymphoma (ALK+ LBCL) is a very rare aggressive B-cell lymphoma presenting significant diagnostic challenges due to their rarity and unique immunophenotypic features. ALK is a tyrosine kinase receptor and is expressed by ALK+ LBCL due to ALK rearrangement. Aim: To analyse the histopathological features including morphology and immunophenotype, clinical details, pattern of care, progression-free survival (PFS) and overall survival of cases diagnosed as ALK+ LBCL. Materials and Methods: This clinicopathological retrospective descriptive study was conducted in the Department of Pathology at a Tertiary Care Cancer Centre, Thiruvananthapuram, Kerala, India. The duration of the study was six months, from January 2022 to June 2022. All the cases of ALK+ LBCL were diagnosed over a period of 10 years, from January 1st 2010 to December 31st 2020. The cases of LBCL diagnosed during the 10 year period were reviewed. Clinical details were obtained from the case sheets of the cases diagnosed as ALK+ LBCL and summarised. Data collection variables included age, sex, stage, nodal and extranodal status, bone marrow, Central Nervous System (CNS) involvement, haemoglobin, Total Leukocyte Count (TLC) and platelet count, Lactate Dehydrogenase (LDH) value, performance status, date of diagnosis, date of treatment started, date of progression, date of last follow-up, date of death (if dead). Review of Haematoxylin &amp; Eosin (H&amp;E) sections and immunohistochemical slides were done and observations were recorded. Descriptive statistics was used to summarise the basic features of the dataset and Kaplan-Meier method was used for calculation of survival. Results: The age of study participants was ranged from 16- 56 years. During the 10 year period, LBCL accounted for 2415 cases. Among these, ALK+ LBCL constituted 6 (0.25%) cases. There was a male predilection (n=5). Blood counts were normal except for anaemia in three patients. LDH was raised in all the patients. Advanced stage disease was present in two patients. Histopathologically, tumour cells in all the cases showed plasmablastic morphology. Immunohistochemistry (IHC) revealed plasma cell immunophenotype and positivity for ALK in all the cases. Cytokeratin (CK) and Epithelial Membrane Antigen (EMA) were positive in three cases simulating carcinomas. Six year overall survival and progression free survival in the present study was 50% and 33.3%, respectively. Conclusion: Careful interpretation of the morphology and immunophenotype is essential for diagnosis of ALK+ LBCL, as it can be easily misdiagnosed as a non haematological malignancy thus, affecting the treatment and prognosis in these patients.

Analysis of Postoperative Complications of Minimally Invasive Surgery for Carcinoma of Oesophagus: A Single Centre Retrospective Cohort Study

Introduction: Traditional transthoracic oesophagectomy is associated with high perioperative morbidity. Minimally Invasive Oesophagectomy (MIE) techniques have been shown to have a decreased incidence of respiratory complications and an improvement in perioperative outcomes, such as length of hospital stay and wound infection rates. Aim: To evaluate the incidence of postoperative respiratory complications, 30-day mortality, and length of hospital stay among patients with carcinoma of the oesophagus undergoing, VideoAssisted Thoracoscopic Surgery (VATS) oesophagectomy. Materials and Methods: A cross-sectional study was conducted in the Department of Anaesthesiology in a new thoracic oncology unit at a Tertiary Cancer care centre, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India. A total of 67 patients with resectable oesophageal cancer who underwent VATS oesophagectomy from September 2019 to December 2021 were included. Patients who had surgery by open thoracotomy and inoperable cases were excluded. The patients’ clinicodemographic profile, intraand postoperative variables, and complications were studied. Descriptive statistics were used for analysis. A p-value ≤0.05 was considered statistically significant at a 5% level of significance. Results: Out of 67 patients, 45 (67.2%) were male, and 22 (32.8%) were female. The age ranged from 33 to 78 years with a median age of 55 years (IQR 47-61). The median body weight was 45 kg (IQR 42-53). Nineteen (28.4%) patients developed postoperative complications, including respiratory distress in 7 (10.4%) and anastomotic leakage in 5 (7.5%) patients. Other complications included symptomatic Coronavirus Disease 2019 (COVID-19) infection, pneumonia, mediastinitis, Multiorgan Dysfunction Syndrome (MODS) with sepsis, seizure and cardiac arrest, and surgical re-exploration. The 30-day mortality was 2.98%. The median length of hospital stay was 19 days (Interquantile Range (IQR) 16-22), which was higher in those with complications (p&lt;0.001). One-lung ventilation was associated with a higher risk of postoperative respiratory complications (p=0.077). Conclusion: VATS oesophagectomy, even in a new thoracic oncology unit, was associated with lower perioperative complications, a shorter hospital length of stay, and decreased mortality compared to historical controls.

Bacteriological profile and antibiotic sensitivity pattern of clinical isolates in a tertiary cancer care center

Bacteriological profile and antibiotic sensitivity pattern of clinical isolates in a tertiary cancer care center

Role of simplified testing strategy for cytogenetic abnormalities in children diagnosed with precursor B-cell acute lymphoblastic leukemia: An experience from tertiary cancer care centre

Role of simplified testing strategy for cytogenetic abnormalities in children diagnosed with precursor B-cell acute lymphoblastic leukemia: An experience from tertiary cancer care centre

Correlation NKX2.2 IHC and EWSR1 break-apart FISH in the diagnosis of Ewing sarcoma: Can combined NKX2.2 and CD99 immunoexpression obviate or minimize the need of FISH testing? First assessment study from Indian tertiary cancer care center.

Ewing sarcoma (ES) are malignant small round cell tumors (MSRCT) characterized by rearrangements of EWSR1 gene. Although gold standard for diagnosis is detection of specific fusion genes by molecular testing, these ancillary tests are costly and only available in limited number of settings. There is a persuasive evidence for reliability of NKX2.2 immunohistochemistry (IHC) as a surrogate marker for EWSR1 gene rearrangement in ES. The aim of this study is to correlate the NKX2.2 immuno-expression with genetically confirmed ES cases and also to assess the reliability and accuracy of NKX2.2 along with combined positivity of NXX2.2 and CD99 in diagnosing ES and differentiating it from other relevant histological mimics. The present study is a retrospective study conducted over a period of 6-year duration in a tertiary cancer care center. We evaluated NKX2.2 immunoexpression in 35 genetically confirmed cases of ES and also in pertaining differential entities (n = 58) of ES including rhabdomyosarcoma (n = 20), lymphoblastic lymphoma (n = 14), Wilms tumor (n = 10), poorly differentiated synovial sarcoma (n = 4), small-cell osteosarcoma (n = 4), neuroblastoma (n = 5), and mesenchymal chondrosarcoma (n = 1). CD99 was performed in the category of MSRCTs showing NKX2.2 positivity to evaluate combined specificity for the diagnosis of ES. Of the 35 genetically confirmed cases of ES, 29 cases (83%) showed NKX2.2-positive expression (83% sensitivity). Compared to ES, NKX2.2 was positive in only 05% cases (3/58 cases) of non-ES MSRCT. Only two of five cases of neuroblastomas and one case of mesenchymal chondrosarcoma showed NKX2.2 positivity. CD99 positivity was seen in 100% of ES and in the single case of mesenchymal chondrosarcoma. All five cases (100%) of neuroblastoma were negative for CD99. The presented study, which is the first from an Indian oncology center, showed NKX2.2 IHC is quite reliable in diagnosis of ES in the right clinicopathological context. With remarkable sensitivity and specificity of NKX2.2 IHC for diagnosis of ES, we propose that combined positivity of CD99 and NKX2.2 IHC can obviate or minimize the need of EWSR1 gene rearrangement molecular testing for diagnosis of ES.

Marjolin’s ulcer – epidemiology and the pattern of care: Experience from a tertiary cancer care center

Background: Marjolin’s ulcer (MU) reflects the malignant transformation of scar tissue or chronic inflammatory skin lesions. Due to the low incidence, only a few case reports and case series were reported in the literature to date. Aims and Objectives: In our retrospective analysis, we report our experience regarding MU over the past 16 years with a significant range of latent period, histology, and as well as underlying skin conditions, from Kolkata, India. Materials and Methods: This was a single institutional retrospective study carried out in the department of radiotherapy at the tertiary cancer, Kolkata. We focus mainly on data pertaining to the type of injury, the time gap between the initial injury and development of MU, histology, clinical stage, and treatment received, along with demographic details. Results: A total of 39 patients with histopathologically proved MUs were included according to the inclusion and exclusion criteria. The median age of patients at the time of development of MU was 52 years and with a range of 32–71 years. Out of 39 patients who participated in this study, 29 were male (74%) and ten were female (26%), 31 patients have localized disease (80%) and eight patients have metastatic disease (20%). The most common histology is squamous cell carcinoma and the least common histology was spindle cell sarcoma. The majority of the patients were treated with curative intention and a small proportion of patients were offered palliative therapy. Conclusion: Ulcers refractory to basic wound care, chronic in nature, and recent change of character of long-standing scar or wound, diagnosis of MU should be ruled out by biopsy. The management of MU should be supervised by a multidisciplinary tumor board and in the areas of epidemiology and treatment, more research is needed.

Real World Experience with Osteosarcoma from a Tertiary Cancer Centre in India

Background: Osteosarcoma represents the commonest category of bone tumors in the children and young adults and stability in its incidence rates have been observed throughout the world. The present study evaluated the varied profile of Indian patients with osteosarcoma with a special emphasis on the survival patterns in a tertiary cancer care centre in India.

Impact of Anterior Commissure Involvement and Frozen Guided Resections on Oncological Outcomes after Laser Cordectomy in Early Glottic Cancers – A 10-year Retrospective Analysis from a Tertiary Care Cancer Center in India

Background: Early glottic cancers can be treated using different options such as transoral laser microsurgery (TLM), open partial laryngectomy (OPL), and radiation therapy (RT). TLM provides similar oncological benefits to OPL in a few subsets of patients, and the quality of voice is comparable to RT, while hospitalization time is reduced. Resection by laser microsurgery of early glottic cancer with anterior commissure involvement (ACI) is more challenging mainly due to difficulty in adequate exposure. The frozen section is reliable in TLM for determining the extent of resection and the real depth which may be masked on videoscopy. Materials and Methods: This study is a retrospective analysis of patients with early glottic cancer (Tis, T1) who underwent TLM in a tertiary cancer center in South India from January 1, 2012, to December 31, 2019. All patients were identified from the hospital registry. Results: The study included 89 patients, and the median follow-up was 54 months. Out of 89 patients, 14 patients had local recurrence which was managed with salvage TLM/salvage RT/salvage laryngectomy. There were three patients with nondisease-specific deaths. Among the study population, the laryngeal preservation rate was 96.6%, the cause-specific survival rate was 100%, and the overall survival rate was 97.7%. The 3-year disease-free survival rate was 84.4%. ACI and frozen margin positivity were statistically significant poor prognostic factors. Conclusion: TLM is a safe and effective treatment of early glottic carcinoma. Apart from tumor (T) staging, ACI and frozen positivity were negative predictive factors. The results suggest the need to consider ACI in the T staging of glottic tumors. Frozen positivity helps us in re-excision but signifies that the disease is deeply infiltrative or aggressive and a vigilant follow-up is required for these patients.

Clinico-epidemiological profile and outcomes of extracranial germ cell tumours in paediatric age group in a tertiary care cancer centre in Northeast India

Clinico-epidemiological profile and outcomes of extracranial germ cell tumours in paediatric age group in a tertiary care cancer centre in Northeast India

Knowledge attitude and practices in febrile neutropenia among nurses at a tertiary care cancer centre

Knowledge attitude and practices in febrile neutropenia among nurses at a tertiary care cancer centre

Morphological Characteristics, Immunophenotyping and Cytogenetics in Acute Myeloid Leukaemia Patients at a Tertiary Care Centre, Gujarat, India

Introduction: Acute Myeloid Leukaemia (AML) is a group of disorders characterized by a spectrum of clinical, morphological, immunophenotypic and associated chromosomal abnormalities. The identification of cytogenetic abnormalities at diagnosis is important for the evaluation of the response to therapy and the identification of an early re-emergence of disease. Aim: To examine the morphological characteristics of AML and emphasize the role of immunophenotyping and cytogenetics in subtyping AML. Materials and Methods: The cross-sectional study was a prospective study that took place from June 2018 to November 2021 at a tertiary-care cancer center, Department of Oncopathology in Gujarat, India. Following the inclusion and exclusion criteria, a total of 232 patients were diagnosed, with 21 being eliminated owing to the unavailability of samples for cytogenetic testing. Diagnosis of AML was based on morphology of Bone Marrow (BM) aspirates and flow cytometric immunophenotyping. Chromosomal analysis was performed on BM and peripheral blood by using standard cytogenetic technique. Results: There were 115 (54.50%) males and 96 (45.49%) females with age group between 1-72 years. The most common subtype was diagnosed as AML M1. Flow cytometry was done on 178 (84.36%) bone marrow and 33 (15.63%) peripheral blood samples. The CD33, CD13, MPO and CD117 were expressed in the vast majority of AML patient, aberrant expression of CD7and CD19 was seen. Total case 121 (57.34%) had normal karyotypes (the majority of cases), 86 (40.75%) cases had anomalous karyotypes consistent with t (8;21), t (15;17), and Inv16, and 4 (1.89%) cases were non informative. Conclusion: The study concluded that flow cytometry and cytogenetics should be performed routinely in all cases of AML. A multimodal diagnostic approach combining cytomorphology, multiparametric flow cytometry accompanied by cytogenetic is needed to arrive at definitive diagnosis of AML.

The prevalence and correlates of comorbidities among patients with cancer attending a tertiary care cancer center in South India: An analytical cross-sectional study.

Comorbidities in patients with cancer can affect treatment, and should, therefore, be prioritized and managed. Our primary aim was to assess the prevalence of comorbidities among patients with cancer. The secondary objective was to identify the association of comorbidities with various sociodemographic and clinical variables. This was a cross-sectional study conducted between December 2019 and March 2020 among patients with cancer, seeking treatment at Malabar Cancer Center, in Kannur District of northern Kerala in South India. Semi-structured interviews were conducted, and comorbidities were assessed using the Charlson Comorbidity Index. The anthropometric measurements were recorded using a standardized instrument and protocol. We enrolled 242 patients in this study. There were 148 (61.2%) female patients; 106 (43.8%) were aged between 41 and 50 years. Cancers of the head-and-neck and breast accounted for the majority of cases (23.1% each, n = 56), followed by the digestive system (18.6%, n = 45) and female reproductive system (11.2%, n = 27). The most common primary cancers in the head-and-neck, digestive, and female reproductive systems were oral, colorectal, and cervical, respectively. The prevalence of comorbidities among patients with cancer was 70.2% (n = 170). Common comorbidities were hypertension (n = 82 ; 33.9%), arthritis (n = 57; 23.6%), and diabetes (n = 53; 21.6%). After controlling for potential confounders, the factors noted to be independently associated with the presence of comorbidities were advanced age, family history of comorbidity, normal weight or underweight, and cancer treatment for more than 6 months' duration. The high prevalence of comorbidities among patients with cancer suggests the need for an integrated system of care and management as the comorbidities affect the overall management of cancer treatment and care.

PD-1 and PD-L1 Expression in Indian Women with Breast Cancer.

The interaction between programmed cell death protein 1 (PD-1) on activated T-lymphocytes and programmed death-ligand 1 (PD-L1) on tumor cells or antigen-presenting cells sends immunosuppressive signals leading to the escape of tumor cells from the host anti-tumor immune response. Inhibiting this interaction with antibodies against PD-1 or PD-L1 is emerging as a valuable therapeutic strategy. However, tissue distribution patterns for PD-L1 and PD-1 in breast cancer patients from India are not reported, yet many clinical trials are underway. In this study the expression of PD-1 and PD-L1 in breast cancer patient samples from India was characterized. The study included 392 cases of operated breast cancer (2012-2017) from a tertiary cancer care center in Bangalore, Karnataka, India. Paraffin blocks were retrievable and receptor status was known. Immunohistochemistry (IHC) was performed using anti-PD-L1 and anti-PD-1 antibodies. RNA was isolated from 76 fresh tumors and nine adjacent normal tissues (2019). PD-L1 transcript levels were measured by RT-qPCR using Hypoxanthine-guanine phosphoribosyl transferase (HPRT) as a reference gene. Based on IHC, PD-1 expression within tumor-infiltrating immune cells (TIICs) was observed in 55/385 cases (14%) across all breast cancer types. In triple-negative breast cancer (TNBC), 21/132 cases (16%) showed PD-1 staining in TIICs. The overall expression of PD-L1 in breast tumor cells across all breast cancer subtypes and TIICs was 11% (41/378) and 39% (151/385), respectively. A relatively higher proportion of TNBC cases had PD-L1 expression in tumor cells (17/132 cases, 13%) and immune cells (68/132 cases, 52%). We also detected PD-L1 transcript expression by qRT-PCR in freshly isolated tumor samples. These findings show that around 52% (68/132) of the TNBC cases express PD-L1 in TIICs. Hence, anti-PD-1/PD-L1 therapy alone or combined with chemotherapy may be a promising treatment for TNBC in Indian patients.