Immunohistochemical determination of estrogen and progesterone receptors in breast cancer: pathological correlation and prognostic indicators

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Abstract

Carcinoma of the breast is the most common malignancy of women globally and the incidence has more risen in recent years. The current study was conducted with the objective of assessing estrogen receptor (ER) and progesterone receptor (PR) reactivity patterns of mammary cancers and to evaluate their association with clinicopathological features. A total of 61 cases of breast carcinoma were examined retrospectively using immunostains for estrogen receptor (ER) and progesterone receptor (PR). Staining pattern and intensity were correlated with histological subtypes and nuclear grades of tumors. The left breast was more commonly involved (57%) and tumor size ranged from 0.5-13.0cm. The predominant morphology was infiltrating ductal carcinoma (85.3%). The majority of the cases presented as grade II (55.3%) lesions with tumor necrosis (70%) and lymph node involvement (71.3%(. Positive nuclear staining for ER and PR was observed in 70.5% and 57.5%  of invasive carcinomas, respectively. In ER+ cases, fifty five cases (90%) gave diffuse immunohistochemical reaction for ER; In the remaining 10%, a focal ER reaction was seen. In PR+ cases, 49 cases (80%) gave diffuse immunohistochemical reaction for PR and In remaining 20% of PR+ tumors, the reaction was heterogeneous. In ductal infiltrative carcinomas the percentage of cases showed ER+ nuclear labeling is higher than those in cases of infiltrative lobular carcinomas. Assessment of ER and PR as prognostic markers for the clinical management of breast cancer patients is strongly advocated to provide best therapeutic options.

Keywords: Breast cancer; Estrogen receptor (ER); Progesterone receptor; Immunohistochemical reaction; Prognostic markers

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1. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer 2001; 94:153- 6. [PubMed]
https://doi.org/10.1002/ijc.1440
PMid:11668491
2. Bhurgri Y, Kayani N, Faridi N, et al. Patho-epidemiology of breast cancer in Karachi '1995-1997'. Asian Pac J Cancer Prev 2007;8:215-20. [PubMed]
PMid:17696734
3. Mori I, Yang Q, Kakudo K. Predictive and prognostic markers for invasive breast cancer. Pathol Int 2002;52:186-94. [PubMed]
https://doi.org/10.1046/j.1440-1827.2002.01335.x
PMid:11972862
4. Fatima S, Faridi N, Gill S. Breast cancer. Steroid receptors and other prognostic indicators. J Coll Physicians Surg 2005;15:230-3. [PubMed]
5. Harvey JM, Clark GM, Osborne CK, et al. Estrogen receptor status by immunohistochemistry is superior to the ligand binding assay for predicting response to adjuvant endocrine therapy in breast cancer. J Clin Oncol. 1999;17:1474-1481. [PubMed]
https://doi.org/10.1200/JCO.1999.17.5.1474
PMid:10334533
6. Sohn DM, Kim SY, Baek MJ, Lim CW, Lee MH, Cho MS, Kim TY. Expression of survivin and clinical correlation in patients with breast cancer. Biomed Pharmacother 2006;60(6):289-292. [PubMed]
https://doi.org/10.1016/j.biopha.2006.06.008
PMid:16876381
7. Al Dhaheri Y, Eid A, AbuQamar S, Attoub S, Khasawneh M, Aiche G, Hisaindee S, Iratni R. Mitotic arrest and apoptosis in breast cancer cells induced by Origanum majorana extract: upregulation of TNF-alpha and downregulation of survivin and mutant p53. PLoS One 2013; 8(2):e56649.
https://doi.org/10.1371/journal.pone.0056649
PMid:23451065 PMCid:PMC3579842
8. Rakha EA. Pitfalls in outcome prediction of breast cancer. J Clin Pathol 2013;66(6):458-464. [PubMed]
https://doi.org/10.1136/jclinpath-2012-201083
PMid:23618694
9. John K. C. Chan, Yiu-Tung Ip, Wah Cheuk.The Utility of Immunohistochemistry for Providing Genetic Information on Tumors. International Journal of Surgical Pathology 2013;21:455-475.
https://doi.org/10.1177/1066896913502529
PMid:24065374
10. Yousif NG. Fibronectin promotes migration and invasion of ovarian cancer cells through up-regulation of FAK-PI3K/Akt pathway. Cell Biol Int 2014;38(1):85-91. [PubMed]
https://doi.org/10.1002/cbin.10184
PMid:24115647
11. Yamauchi H, Stearns V, Hayes DF. When is a tumor marker ready for prime time? A case study of c-erbB-2 as a predictive factor in breast cancer. J Clin Oncol 2010;19:2334-56.
https://doi.org/10.1200/JCO.2001.19.8.2334
PMid:11304787
12. Maynard PV, Davies CJ, Blamey RW, et al. Relationship between oestrogen-receptor content and histological grade in human primary breast tumours. Br J Cancer 1978;38:745-8. [PubMed]
https://doi.org/10.1038/bjc.1978.282
PMid:743491 PMCid:PMC2009828
13. Hilf R, Feldstein ML, Savlov ED, Gibson SL, Seneca B. The lack of relationship between estrogen receptor status and response to chemotherapy. Cancer 1980; 46 (12 Suppl):2797-800. [PubMed]
https://doi.org/10.1002/1097-0142(19801215)46:12+<2797::AID-CNCR2820461411>3.0.CO;2-B
14. UICC. TNM Classification of Malignant Tumour Geneva. International Union Against Cancer 1968.
15. H Lee, A G Douglas-Jones, J M Morgan, B Jasani J. The effect of fixation and processing on the sensitivity of oestrogen receptor assay by immunohistochemistry in breast carcinoma. Clin. Pathol 2002;55:236-238. [Pubmed]
https://doi.org/10.1136/jcp.55.3.236
16. Pertschuk LP, Feldman JG, Kim YD, et al. Estrogen receptor immunocytochemistry in paraffin embedded tissues with ER1D5 predicts breast cancer endocrine response more accurately than H222Sp in frozen sections or cytosol-based ligand-binding assays. Cancer 1996;77:2514-2519. [PubMed]
https://doi.org/10.1002/(SICI)1097-0142(19960615)77:12<2514::AID-CNCR14>3.0.CO;2-V
17. Ramos-Vara JA. Technical Aspects of Immunohistochemistry. Veterinary Pathology 2005;42:405-426. [PubMed]
https://doi.org/10.1354/vp.42-4-405
PMid:16006601
18. Lazennec G, Bresson D, Lucas A, Chauveau C, Vignon F. ERβ inhibits proliferation and invasion of breast cancer cells. Endocrinology 2001;142:4120-4130.
https://doi.org/10.1210/endo.142.9.8395
PMid:11517191 PMCid:PMC2040491
19. Anderson E, Clarke RB, Howell A. Estrogen responsiveness and control of normal human breast proliferation. J Mammary Gland Biol Neoplasia 1998;3:3-5. [PbMed]
https://doi.org/10.1023/A:1018718117113
https://doi.org/10.1023/A:1018714016205
20. Palmieri C, Cheng GJ, Saji S, et al. Estrogen receptor beta in breast cancer. Endocrine-Related Cancer 2002;9:1-13.
https://doi.org/10.1677/erc.0.0090001
PMid:11914179
21. Burak Jr WE, Quinn AL, Farrar WB, Brueggeneier RW. Androgens influence estrogen-induced responses in human breast carcinoma cells through cytochrome P450 aromatase. Breast Cancer Res Treat 1997;44:57-64. [PubMed]
https://doi.org/10.1023/A:1005782311558
PMid:9164678
22. Hashmi AA, Edhi MM, Naqvi H, Faridi N, Khurshid A, Khan M. Clinicopathologic features of triple negative breast cancers: an experience from Pakistan. Diagn Pathol 2014;28;9(1):43. [PubMed]
23. Tanriverdi O, Meydan N, Barutca S. Reconsideration of clinical and histopathological prognostic factors in breast cancer patients: a single center experience. Asian Pac J Cancer Prev 2014;15(2):807-12.
https://doi.org/10.7314/APJCP.2014.15.2.807
PMid:24568500
24. Werner M, Chott A, Fabiano A, et al. Effect of formalin fixation and processing on immunohistochemistry. Am J Surg Pathol 2000;24:1016-1019. [PubMed]
https://doi.org/10.1097/00000478-200007000-00014
PMid:10895825
25. Goldstein NS, Ferkowicz M, Odish E, et al. Minimum formalin fixation time for consistent estrogen receptor immunohistochemical staining of invasive breast carcinoma. Am J Clin Pathol 2003;120:86-92.
https://doi.org/10.1309/QPHDRB00QXGMUQ9N
PMid:12866377
26. Diallo R, Schaefer K, Poremba C, et al. Monoclonality in normal epithelium and in hyperplastic and neoplastic lesions of the breast. J Pathol 2001;193:27-32. [PubMed]
https://doi.org/10.1002/1096-9896(2000)9999:9999<::AID-PATH747>3.0.CO;2-H
27 Alers J, Krijtenburg P, Vissers C, et al. Cytogenetic heterogeneity and histologic tumor growth patterns in prostatic cancer. Cytometry 1995;21:84-94.
https://doi.org/10.1002/cyto.990210116
PMid:8529477
28. Kuiper GG, Carlsson B, Grandien K, Enmark E, Haggblad J, Nilsson S, Gustafsson JA. Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta. Endocrinology 1997;138:863-870. [PubMed]
https://doi.org/10.1210/endo.138.3.4979
PMid:9048584
29. Qiao EQ, Ji M, Wu J, et al. Joint detection of multiple immunohistochemical indices and clinical significance in breast cancer. Mol Clin Oncol 2013;1(4):703-710.
https://doi.org/10.3892/mco.2013.111
PMid:24649232 PMCid:PMC3915321
30. Hall JM, McDonnell DP. The estrogen receptor beta-isoform (ER beta) of the human estrogen receptor modulates ER alpha transcriptional activity and is a key regulator of the cellular response to estrogens and antiestrogens. Endocrinology 1999;140:5566-5578. [PubMed]
https://doi.org/10.1210/endo.140.12.7179
PMid:10579320

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Research Article
DOI: http://dx.doi.org/10.18081/2333-5106/014-12/1229-1239
American Journal of BioMedicine Volume 6, Issue 8, pages 276-288
Received January 30, 2016; Accepted June 25, 2016; Published August 08, 2016

How to cite this article
AI-Timimi A,Yousi NG. Immunohistochemical determination of estrogen and progesterone receptors in breast cancer: pathological correlation and prognostic indicators. American Journal of BioMedicine 2016;4(3):265-275

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1. Abstract
2. Keywords
3. Introduction
4. Methods
5. Results
6. Discussion
7. References

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