High prevalance of triple negative markers in breast cancer patients in North Maharashtra

Abstract

Breast cancer is the most prevalent cancer among women worldwide. The Bloom Richardson grading has been applied to most breast cancers. There are different biologic subtypes of breast cancer according to immunohistochemistry (IHC). Clinically, these subtypes are characterized on the basis of expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Among them, Triple Negative Breast Cancer (TNBC) which lacks expression of the ER, PR, and HER-2-neu, is most aggressive form. TNBC cases have worse prognosis, require aggressive chemotherapy and are difficult to manage. The advent of neoadjuvant chemotherapy has highlighted the importance of IHC, Breast Ca and TNBC. The aim and objective of this study is to find prevalence of TNBC in Breast Cancer patients in North Maharashtra. This is a 3- Year ambiceptive analysis done to study the incidence of TNBC among Breast Cancer cases. Out of 58 Breast Cancer cases diagnosed in our institute, 30 cases in which IHC was done were included in this study. Postmortem breast cancer cases, core needle biopsies and mastectomies in which IHC was not done were excluded. Among 30 cases studied, 53.33% cases were TNBC, 23.33% cases were ER and PR positive, 10% cases were only HER-2-neu positive, 6.66% cases were only ER positive, 3.33% cases were only PR positive, and 3.33% cases were all three ER, PR and HER-2 neu positive. To conclude, India has considerably higher prevalence of TNBC, as compared to the Western countries. This finding has significant clinical relevance as it may have contributed to poor outcomes in patients with breast cancer in India. With advent of neoadjuvant chemotherapy, use of Modified Bloom- Richardson Grading & IHC is of crucial importance. To understand the determinants of TNBC in India additional research is needed for diagnosis and treatment follow-up.