Histopathological Prognostic Factors In Carcinoma Breast - An Indian Institutional Experience
Abstract
Objective: Pathological prognostic factors in breast cancer are now widely used to predict biological behavior of cancer and to plan its effective management. In this paper, we attempt to evaluate the reports from our histopathology laboratory spanning over a period of 2 years. The aim of this descriptive study was to see the various histopathological features of breast cancer in order to know the pattern of disease in recent time in India.
Methods: The pathology reports of primary carcinoma of the breast diagnosed in our laboratory from 1st January 2010 to 31st December 2012 (2 year period) were reviewed for details on tumor size, histological type and grade, presence or absence of tumor emboli in vascular channels and lymph node status.
Results: Total of 174 patients was included in the study. The mean age of presentation was 47.84 years. In 86 cases the lump was palpable in the upper lateral quadrant, followed by 52 cases in the upper medial quadrant. Duct cell carcinoma was the most common histological subtype (148 cases) accounting for 85% of the cases. Mucinous carcinoma was the second most common, occurring in 7 cases (4%). 81.61 % of tumours were grade II. Highest number of tumours were detected in the T2 stage i.e with size varying between 2 – 5 cms (67.24%). In decreasing frequency T3 > T1 > T4 stage tumours were observed. More number of cases in our study population belonged to either N0 category or N1 category. 90 cases had lymphovascular invasion in our study accounting for 51.72%.
Conclusion: Our study puts forth the trends in histopathological prognostic factors in primary carcinoma breast in India.
Downloads
References
2. Organization WH. The global burden of disease: 2004 update: Department of Health Statistics and Informatics; 2008. Report No.: ISBN 978b 9 4 156 3710.
3. Rosen PP. The pathological classification of human mammary carcinoma: Past, present and future. Ann Clin Lab Sci 1979;9(2):144–156. [PubMed]
4. Fitzgibbons et al. Prognostic Factors in Breast Cancer. Arch Pathol Lab Med.2000;124(7):966-978. [PubMed]
5. Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology 1991;19(5):403–10. [PubMed]
6. Galea MH, Blamey RW, Elston CE, Ellis IO. The Nottingham Prognostic Index in primary breast cancer. Breast Cancer Research & Treatment 1992;22(3):207-219. [PubMed]
7. National Cancer Registry Program: Ten year consolidated report of the Hospital Based Cancer Registries, 1984–1993, an assessment of the burden and care of cancer patients. Indian Council of Medical Research, New Delhi, 2001.
8. Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS: Spectrum of breast cancer in Asian women. World J Surg 2007;31(5):1031–40. [PubMed]
9. Nandakumar A, Anantha N, Venugopal TC, Sankaranarayanan R, Thimmasetty K, Dhar M: Survival in breast cancer: a population-based study in Bangalore, India. Int J Cancer 1995;60(5):593–6. [PubMed]
10. National Cancer Registry Programme: Consolidated report of the population based cancer registries 1990–1996. Indian Council of Medical Research, New Delhi, 2001.
11. Saxena S, Rekhi B, Bansal A, Bagga A, Chintamani, Murthy NS: Clinico-morphological patterns of breast cancer including family history in a New Delhi hospital, India – a cross-sectional study. World J Surg Oncol 2005;3:67.
12. Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, Vijver MJ van de. WHO Classification of Tumours of the Breast . 4th ed. Geneva. WHO press; 2012.
13. Bloom HJG. Prognosis in carcinoma of the breast. Br J Cancer 1950;4(3):259–288. [PubMed]
14. Bloom HJG, Richardson WW. Histological grading and prognosis in breast cancer. A study of 1049 cases, of which 359 have been followed 15 years. Br J Cancer 1957;11(3):359–377. [PubMed]
15. Dinshaw KA, Budrukkar AN, Chinoy RF, Sarin R, Badwe R, Hawaldar R, Shrivastava SK: Profile of prognostic factors in 1022 Indian women with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 2005;63(4):1132–41.
16. Hopton DS, Thorogood J, Clayden AD, et al. Histological grading of breast cancer; significance of grade on recurrence and mortality. Eur J Surg Oncol 1989;15(1):25–31. [PubMed]
17. Thoresen S. Histological grading and clinical stage at presentation in breast carcinoma. Br J Cancer 1982;46(3):457–458. [PubMed]
18. Le Doussal V, Tubiana-Hulin M, Friedman S, et al. Prognostic value of histologic grade nuclear components of Scarff-Bloom-Richardson (SBR). An improved score modification based on a multivariate analysis of 1262 invasive ductal breast carcinomas. Cancer 1989;64(9):1914–1921.
19. Davis BW, Gelber RD, Goldhirsch A, et al. Prognostic significance of tumor grade in clinical trials of adjuvant therapy for breast cancer with axillary nodal metastases. Cancer 1986;58(12):2662–2670.
20. Williams MR, Blamey RW, Todd JH, et al. Histologic grade in predicting response to endocrine treatment. Breast Cancer Res Treat 1986;8(2):165–166. [PubMed]
21. Yoshimoto M, Sakamoto G, Ohashi Y. Time dependency of the influence of prognostic factors on relapse in breast cancer. Cancer 1993;72(10):2993–3001. [PubMed]
23. Say CC, Donegan WL. Invasive carcinoma of the breast: Prognostic significance of tumor size and involved axillary lymph nodes. Cancer 1974;34(2):468–471. [PubMed]
24. Simpson JF, Gray R, Dressler LG, Cobau CD, Falkson CI, Gilchrist KW et al. Prognostic value of histologic grade and proliferative activity in axillary node-positive breast cancer: results from the Eastern Cooperative Oncology Group Companion Study, EST 4189. J Clin Oncol. 2000; 18(10): 2059-69.
OAI - Open Archives Initiative
