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Correlation of cytokeratin expression with bloom richardson grading of carcinoma breast in rural setup.
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| Author:
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PREETI MISHRA, SUNITA VAGHA, SAMARTH SHUKLA, S.S. CHAUDHARI
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| Abstract:
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Background:Carcinoma breast is the most common female cancer (1).Based on GLOBOCAN estimates 14.1 million incidence and 8.2 million cases of deaths related to were found in 2012 (2). At the time of clinical finding the bulk have breached the basement membrane and invaded the stroma. Various Prognostic factor of carcinoma breast are age, stage, spread to LN, Hormone receptor, IHC marker, BR grading system (3). BR grading has powerful prognostic value. It is combined with LN stage and size of tumor to form prognostic indices which is also incorporated in algorithm to establish the use of adjuvant chemotherapy (4). Various immunophenotypes have been established in breast carcinoma,these immunophenotypes are based on hormone receptor, cell proliferation indices and Herceptin receptor status. (ER,PR,Ki67,Her2neu). Based on this Immunophenotype the breast cancers (IDC) have been classified as Luminal A, Luminal B, Her 2 neu, TNBC (5). High grade breast cancers mostly of Basal cell type, a subcategory of TNBC are usually detected with the help of CK 5/6. The present study would like to evaluate the utility of cytokeratin in comparision with Bloom Richardson grading and immunophenotype markers and to evaluate this efficacy in assessing grade of Breast Carcinoma.
Objectives: 1) To diagnose and grade breast carcinoma through histopathology, 2)To assess molecular immunophenotype of breast carcinoma, 3)To assess Cytokeratin status, 4)To compare CK status with BR grading and other immunophenotype.
Methodology: The current study is conducted in the histopathology section of Department of Pathology, JNMC, Sawangi (M). The study is approved by IEC and informed consent was taken. The study investigated 50 cases of infiltrating ductal carcinoma.The histopathological grade of tumor is determined by BR grading system.The hormonal status of the tumor is determined by carrying out immunostaining for ER, PR, and Her2 neu and Bloom Richardson grading is correlated with CK expression.
Results: It is anticipated that maximum cases will be in Grade I followed by Grade II and Grade III. Maximum cases will be of luminal B followed by Luminal A and triple negative consist of minimum number of cases. All cases of Luminal A and Luminal B are positive for CK 8 & 18 whereas negative for CK 5 & 6. And all cases of Her2 neu and triple negative are found positive for CK 5 & 6 and negative for CK 8 & 18.
Conclusion: CK expression can aid in differentiating breast cancer into low grade (Luminal A and Luminal B) and high grade (Her 2 neu & triple negative) as per the molecular subtype. In rural setup,instead of using Breast Immunophenotype, CK and BR grading can be used as a single cost effective diagnostic tool in hormone positive breast carcinoma for diagnosis as well as treatment.
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| Keyword:
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Breast carcinoma, Bloom Richardson grading, Immunohistochemistry, Cytokeratins 5/6, Cytokeratin 8/18, Breast immunophenotypes.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2019.11.02.209
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| Download:
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