Estrogen receptor, Progesterone receptor, and human epidermal growth factor receptor-2 status in breast cancer: A retrospective study of 5436 women from a regional cancer center in South India

Rekha Vijay Kumar; Dipti Panwar; Usha Amirtham; Chennagiri Srinivasmurthy Premalata; Champaka Gopal; Suma Mysore Narayana; Geetha Vikram Patil Okaly; K. C. Lakshmaiah; S. Krishnamurthy

doi:10.4103/sajc.sajc_211_17

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ORIGINAL ARTICLE: Breast Cancer

07 (

); 07-10

doi:

10.4103/sajc.sajc_211_17

Estrogen receptor, Progesterone receptor, and human epidermal growth factor receptor-2 status in breast cancer: A retrospective study of 5436 women from a regional cancer center in South India

Rekha Vijay Kumar^1,, Dipti Panwar¹, Usha Amirtham¹, Chennagiri Srinivasmurthy Premalata¹, Champaka Gopal¹, Suma Mysore Narayana¹, Geetha Vikram Patil Okaly¹, K. C. Lakshmaiah², S. Krishnamurthy³

1 Department of Pathology, Kidwai Cancer Institute, Bengaluru, Karnataka

2 Department of Medical Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka

3 Department of Surgical Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka

*Corresponding author: Dr. Rekha Vijay Kumar. rekha_v_kumar@yahoo.co.in

Published: 2020-12-22

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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This article was originally published by Thieme Medical and Scientific Publishers Pvt. Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

Aim: The aim of the study was to analyze the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) status over 7 years in South Indian women with breast cancer. Further analysis of a subgroup was done to study clinically defined subtypes and the role of preanalytical factors in needle core biopsies (NCBs) and excised specimens. Materials and Methods: This was a retrospective study from January 2010 to December 2016. Patients diagnosed with invasive breast cancer and available immunohistochemistry (IHC) reports of ER, PR, and HER2 status were analyzed. The cases for the year 2016 were analyzed further to observe the impact of preanalytical factors on the IHC staining patterns and surrogate status. Results: A total of 5436 patients were included with a median age of 48 years. Among these, 65% were ≤ 55 years. The overall incidence of hormone receptor (HR)-positive patients was 48%; HER2 positive, 15%; and triple-negative breast cancer (TNBC), 37%. The incidence of HR positive, HER2 positive, and TNBC were 45%, 16%, and 39% and 53%, 13%, and 34% in patients <56 years and over 55 years, respectively (P < 0.001). There was an increase in HR positivity and decrease in TNBCs over time. There was no significant difference in the staining patterns in NCBs and excised specimens. Conclusion: With time, there is an increase in hormone-positive tumors which may be attributed to better IHC techniques and tissue handling. There was no statistical difference in the patterns of ER, PR, and HER2 immunostaining in core biopsy and excised specimens.

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References

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Rastelli F, Crispino S. Factors predictive of response to hormone therapy in breast cancer. Tumori 2008;94:370-83.
Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Parmar V, et al. Hormone receptors over the last 8 years in a cancer referral center in India: What was and what is? Indian J Pathol Microbiol 2009;52:171-4.
Bonnier P, Romain S, Charpin C, Lejeune C, Tubiana N, Martin PM, et al. Age as a prognostic factor in breast cancer: Relationship to pathologic and biologic features. Int J Cancer 1995;62:138-44.
Gajdos C, Tartter PI, Bleiweiss IJ, Bodian C, Brower ST. Stage 0 to stage III breast cancer in young women. J Am Coll Surg 2000;190:523-9.
Ghosh J, Gupta S, Desai S, Shet T, Radhakrishnan S, Suryavanshi P, et al. Estrogen, progesterone and HER2 receptor expression in breast tumors of patients, and their usage of HER2-targeted therapy, in a tertiary care centre in India. Indian J Cancer 2011;48:391-6.
Manjunath S, Prabhu JS, Kaluve R, Correa M, Sridhar TS. Estrogen receptor negative breast cancer in India: Do we really have higher burden of this subtype? Indian J Surg Oncol 2011;2:122-5.
Rajan G, Culas TB, Jayalakshmy PS. Estrogen and progesterone receptor status in breast cancer: A cross-sectional study of 450 women in Kerala, South India. World J Surg Oncol 2014;12:120.
Singh R, Gupta S, Pawar SB, Pawar RS, Gandham SV, Prabhudesai S. Receptor expression in patients in semi urban India. J Cancer Res Ther 2014;10:26-28.
Mukherjee G, Lakshmaiah KC, Vijayakumar M, Prabhu JS, Telikicherla D, Sridhar TS,et al. Analysis of clinico-pathological characteristics of Indian breast cancers shows conservation of speci c features in the hormone receptor sub-types. J Integr Oncol 2016;5:159.
Bustreo S, Osella-Abate S, Cassoni P, Donadio M, Airoldi M, Pedani F, et al. Optimal ki67 cut-off for luminal breast cancer prognostic evaluation: A large case series study with a long-term follow-up. Breast Cancer Res Treat 2016;157:363-71.
Anderson WF, Pfeiffer RM, Dores GM, Sherman ME. Comparison of age distribution patterns for different histopathologic types of breast carcinoma. Cancer Epidemiol Biomarkers Prev 2006;15:1899-905.
Anderson WF, Reiner AS, Matsuno RK, Pfeiffer RM. Shifting breast cancer trends in the United States. J Clin Oncol 2007;25:3923-9.
Krishnamurthy S, Poornima R, Challa VR, Goud YG. Triple negative breast cancer-our experience and review. Indian J Surg Oncol 2012;3:12-6.
Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B, et al. Personalizing the treatment of women with early breast cancer: Highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 2013;24:2206-23.
Perou CM, Sørlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, et al. Molecular portraits of human breast tumours. Nature 2000;406:747-52.
Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF, et al. Hormone receptor status of breast cancer in India: A study of 798 tumours. Breast 2000;9:267-70.
Nabi MG, Ahangar A, Wahid MA, Kuchay S. Clinicopathological comparison of triple negative breast cancers with non-triple negative breast cancers in a hospital in North India. Niger J Clin Pract 2015;18:381-6.
Sharma D, Singh G. An institutional analysis of clinicopathological features of triple negative breast cancer. Indian J Cancer 2016;53:566-8.
Ajay A, Radhakrishnan P. Clinical pathological and epidemiological study of triple negative breast cancer. Int J Res Med Sci 2017;5:2657-61.
Sharma M, Sharma JD, Sarma A, Ahmed S, Kataki AC, Saxena R, et al. Triple negative breast cancer in people of North East India: Critical insights gained at a regional cancer centre. Asian Pac J Cancer Prev 2014;15:4507-11.
Patnayak R, Jena A, Rukmangadha N, Chowhan AK, Sambasivaiah K, Phaneendra BV, et al. Hormone receptor status (estrogen receptor, progesterone receptor), human epidermal growth factor-2 and p53 in South Indian breast cancer patients: A tertiary care center experience. Indian J Med Paediatr Oncol 2015;36:117-22.
Adusumilli P, Konatam ML, Gundeti S, Bala S, Maddali L. Treatment challenges of Her2-positive breast cancer. Indian J Med Paediatr Oncol 2017;338:22-7.
Gupta A, Jain J, Kumar A, Kumar S, Wadhwa N. Triple negative breast cancer – An overview and review of literature. Asian J Med Sci 2012;3:16-20.
Kakarala M, Rozek L, Cote M, Liyanage S, Brenner DE. Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S. – A SEER analysis. BMC Cancer 2010;10:191.

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[1] Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69-90.

[2] National Cancer Registry Programme, Indian Council of Medical Research. Leading sites of cancer. In: Consolidated Report of Population Based Cancer Registries 2001-2004, Incidence and Distribution of Cancer. Bangalore: Coordinating Unit, National Cancer Registry Programme (ICMR); 2006. p. 8-30.

[3] Rastelli F, Crispino S. Factors predictive of response to hormone therapy in breast cancer. Tumori 2008;94:370-83.

[4] Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Parmar V, et al. Hormone receptors over the last 8 years in a cancer referral center in India: What was and what is? Indian J Pathol Microbiol 2009;52:171-4.

[5] Bonnier P, Romain S, Charpin C, Lejeune C, Tubiana N, Martin PM, et al. Age as a prognostic factor in breast cancer: Relationship to pathologic and biologic features. Int J Cancer 1995;62:138-44.

[6] Gajdos C, Tartter PI, Bleiweiss IJ, Bodian C, Brower ST. Stage 0 to stage III breast cancer in young women. J Am Coll Surg 2000;190:523-9.

[7] Ghosh J, Gupta S, Desai S, Shet T, Radhakrishnan S, Suryavanshi P, et al. Estrogen, progesterone and HER2 receptor expression in breast tumors of patients, and their usage of HER2-targeted therapy, in a tertiary care centre in India. Indian J Cancer 2011;48:391-6.

[8] Manjunath S, Prabhu JS, Kaluve R, Correa M, Sridhar TS. Estrogen receptor negative breast cancer in India: Do we really have higher burden of this subtype? Indian J Surg Oncol 2011;2:122-5.

[9] Rajan G, Culas TB, Jayalakshmy PS. Estrogen and progesterone receptor status in breast cancer: A cross-sectional study of 450 women in Kerala, South India. World J Surg Oncol 2014;12:120.

[10] Singh R, Gupta S, Pawar SB, Pawar RS, Gandham SV, Prabhudesai S. Receptor expression in patients in semi urban India. J Cancer Res Ther 2014;10:26-28.

[11] Mukherjee G, Lakshmaiah KC, Vijayakumar M, Prabhu JS, Telikicherla D, Sridhar TS,et al. Analysis of clinico-pathological characteristics of Indian breast cancers shows conservation of speci c features in the hormone receptor sub-types. J Integr Oncol 2016;5:159.

[12] Bustreo S, Osella-Abate S, Cassoni P, Donadio M, Airoldi M, Pedani F, et al. Optimal ki67 cut-off for luminal breast cancer prognostic evaluation: A large case series study with a long-term follow-up. Breast Cancer Res Treat 2016;157:363-71.

[13] Anderson WF, Pfeiffer RM, Dores GM, Sherman ME. Comparison of age distribution patterns for different histopathologic types of breast carcinoma. Cancer Epidemiol Biomarkers Prev 2006;15:1899-905.

[14] Anderson WF, Reiner AS, Matsuno RK, Pfeiffer RM. Shifting breast cancer trends in the United States. J Clin Oncol 2007;25:3923-9.

[15] Krishnamurthy S, Poornima R, Challa VR, Goud YG. Triple negative breast cancer-our experience and review. Indian J Surg Oncol 2012;3:12-6.

[16] Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B, et al. Personalizing the treatment of women with early breast cancer: Highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 2013;24:2206-23.

[17] Perou CM, Sørlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, et al. Molecular portraits of human breast tumours. Nature 2000;406:747-52.

[18] Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF, et al. Hormone receptor status of breast cancer in India: A study of 798 tumours. Breast 2000;9:267-70.

[19] Nabi MG, Ahangar A, Wahid MA, Kuchay S. Clinicopathological comparison of triple negative breast cancers with non-triple negative breast cancers in a hospital in North India. Niger J Clin Pract 2015;18:381-6.

[20] Sharma D, Singh G. An institutional analysis of clinicopathological features of triple negative breast cancer. Indian J Cancer 2016;53:566-8.

[21] Ajay A, Radhakrishnan P. Clinical pathological and epidemiological study of triple negative breast cancer. Int J Res Med Sci 2017;5:2657-61.

[22] Sharma M, Sharma JD, Sarma A, Ahmed S, Kataki AC, Saxena R, et al. Triple negative breast cancer in people of North East India: Critical insights gained at a regional cancer centre. Asian Pac J Cancer Prev 2014;15:4507-11.

[23] Patnayak R, Jena A, Rukmangadha N, Chowhan AK, Sambasivaiah K, Phaneendra BV, et al. Hormone receptor status (estrogen receptor, progesterone receptor), human epidermal growth factor-2 and p53 in South Indian breast cancer patients: A tertiary care center experience. Indian J Med Paediatr Oncol 2015;36:117-22.

[24] Adusumilli P, Konatam ML, Gundeti S, Bala S, Maddali L. Treatment challenges of Her2-positive breast cancer. Indian J Med Paediatr Oncol 2017;338:22-7.

[25] Gupta A, Jain J, Kumar A, Kumar S, Wadhwa N. Triple negative breast cancer – An overview and review of literature. Asian J Med Sci 2012;3:16-20.

[26] Kakarala M, Rozek L, Cote M, Liyanage S, Brenner DE. Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S. – A SEER analysis. BMC Cancer 2010;10:191.

Estrogen receptor, Progesterone receptor, and human epidermal growth factor receptor-2 status in breast cancer: A retrospective study of 5436 women from a regional cancer center in South India

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