Abstract :
Background: Breast cancer is the most common malignancy in females. It isroutinely classified according
to the WHO classification. However, molecular classification can be more powerful than histopathology
as a predictive factor for the different treatment strategies.
Aims: This study gives an insight to overall prognosis, role of molecular markers, various molecular
subtypes and better categorization of triple negative breast cancer cases.
Setting and Design: This was a cross sectional study conducted in the department of pathology over a
period of 2 years.
Material and Methods: In this study, 500 cases of breast carcinoma were included. Molecular phenotype
was determined using expression of estrogen receptor, progesterone receptor, HER2/neu, Ki67, epithelial
growth factor receptor (EGFR), and cytokeratin 5/6.
Statistical Analysis Used: Correlation of molecular subtypes with histological grade, prognostic and
predictive factors done by using chi square test. Using software Medcalc version 12.2.1.0.
Results: Of the 500 cases, maximum number of cases 38.20% were luminal A. Most common histological
subtype in all category were Infiltrating duct carcinoma (Not Otherwise Specified) {IDC (NOS)} with
higher grade of IDC (NOS) in her2neu and basal type. Unclassified category includes both low grade
tumors and high grade tumors. Statistically significant association of molecular subtype was found with
histological subtype, tumor necrosis, lymphocytic response and lymphovascular invasion. (P 0.001)
Conclusion: Molecular classification would result in less frequent use of chemotherapy in breast carcinoma
and have its considerable advantages in reducing toxicity and costs.
Key message: In view of increasing awareness, younger age of presentation and occasional family history
various screening program should be popularized.
Keyword :
Breast carcinoma, Cytokeratin 5/6, Estrogen receptor, EGFR, HER2/neu, Ki67, Molecular phenotypes, Progesterone receptor.