Online ISSN: 2515-8260

Clinical presentation and histopathological spectrum of triple negative breast carcinoma at a specialized cancer care center: A retrospective study

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1Amit Kumar, 2Arjun Agarwal, 3Rachit Batra, 4Cheena Garg, 5Aseeb ur Rehman, 6Ashish Bansal


Introduction: Triple negative breast cancers (TNBC) are defined as cancers lacking expression of estrogen receptor, progesterone receptor and Her-2-neu. The diagnosis is based on demonstration of negative receptor expression using immuno-histochemistry and/or Fluorescent in situ hybridization (FISH). The disease has an aggressive course with overall poor prognosis, so accurate and early diagnosis becomes all the more significant for management of these cancers. Aim and Objectives: To assess the clinical and pathological characteristics of TNBC including clinical profile, histopathological type, tumor grade, Ki-67 proliferation index along with expression of estrogen receptor, progesterone receptor and Her-2-neu. Material and Methods: A retrospective study was conducted over period of 3 years and 6 months and the above mentioned clinical and pathological findings were assessed for TNBCs. For estrogen and progesterone receptor evaluation, Allred scoring system was used and a total score of 0-2 was considered as negative. Her-2-neu was considered negative when the staining was negative/faint/barely perceptible in part of membranes (score of 0-1+). In equivocal cases of Her-2-neu expression (3 cases), FISH was done for definitive assessment. Observations: 48 cases of Triple negative breast cancers were studied. Cytological evaluation was done in all the cases with 35 cases being reported as confirmed for a malignant lesion. All the patients were female with mean age of presentation being 46.2 years. The most common clinical presentation was breast lump. Clinically, T2 was the most common tumor stage with 22 cases. All the cases were diagnosed as ‘Invasive Breast Carcinoma, No special type’ with mean Nottingham score of 7.6. The histopathological grade was Grade 2 in 16 cases and Grade 3 in 32 cases. The mean Ki-67 proliferation index was 55%. Conclusion: TNBCs occur in a younger population in India. Majority of patients have histological grade III tumors with high proliferation activity which is one of the reasons for adverse prognosis in these cancers. In cases where immuno-histochemistry is equivocal for Her-2-neu expression, FISH can be used to ascertain the exact status.

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