[102] Invasive Carcinoma of Breast Morphology and Immunohistochemical Classification – King Abdulaziz University Hospital Experience

Fadwa J Altaf, Eman AS Emam, Ghadeer A Mokhtar, Rana Y Bokhary, Lamya A Baharith, Hiba H Ali, Zuhoor K Al- Gaithy. King Abdulaziz University, Jeddah, Western, Saudi Arabia

Background: Management and prognosis of Invasive breast carcinoma (IBC) does not depend any more on pure morphology only, but it also includes the Immunohistochemical features of the tumor based on its content of Estrogen Receptors(ER),Progesterone Receptors(PR),and HER 2 Receptors (HER2). Large numbers of studies publish the new classification based on Immunostains and molecular findings.
Design: A retrospective study is designed to reclassify cases of invasive breast carcinoma received and diagnosed at Anatomical pathology of king Abdulaziz University hospital.We identified 155 cases that fit our inclusion criteria.Patient's age were recorded. We classify them histologically into,invasive ductal carcinoma not otherwise specified(IDCNOS), pure special type (PST) and mixed type (MT).Tumor size was identified, grade was applied to all of the three groups. In addition certain immunohistochemical markers including ER,PR,HER2, P63, Ki67 and other when necessary were applied.
Results: We identify 7 groups (G), Luminal A(ER+,PR+&HER2-). Lumina B (ER+,PR+&HER2+). While HER2+(ER-,PR-&HER2+) & triple negative (ER-,PR-&HER2-). We also have apparent groups(AG 5&6) of Luminal A&B that they lack PR positivity. Apparent HER2+(G7) that lack ER+. Majority of cases 59% are presented between 41-60 years of age, while 13% were below the age of 40yrs. All of our cases were presented with large tumor sizeT2&T3.(Table 1)

Groups, AverageTumor sizeTS,Frequancy %,Grad & Invasive Types
GroupsATScmFrequancy((N)%n155Grade(g)IDCPPSTMTT
Group 1 LuminalA3.255837,4%g1=19,g2=32,g3=742106
Group 2 LuminalB3.622415.5%g1=6,g2=16,g3=21833
Group 3 HER+3.881711%g1=1,g2=10,g3=61511
Group 4 Triple Negative3.862616,8%g1=3,g2=6,g3=172231
Group5 App.Luminal A2.861811.6%g1=5,g2=12,g3=11422
Group6 App.Luminal B2.5106.5%g1=8,g2=2,g3=01000
Group7 App.HER+3.2521.3%g1=0,g2=2,g3=2200
Total 155100.00% 1231913
n= number. cm= centimeter


Conclusions: Lack of breast cancer screening program in the Kingdom resulted in advanced presentation of our cases.Majority of the cases 53% are of luminal group of intermediate grade that will benefit from hormonal treatment. While 11% only exhibit high grad tumors that will benefit from Herceptin treatment. Almost 17% will have more aggressive tumors that does not respond to hormonal or Herceptin treatment, with high tumor grade. There is no morphological difference in the seven groups identified. We recommend breast cancer screening starting before age of 40 and a larger cases sample to be studied in the future to draw a better conclusion.
Category: Breast

Wednesday, March 6, 2013 9:30 AM

Poster Session V # 45, Wednesday Morning

 

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