Histopathological Analysis, Grading and Value of Proliferation Index, Ki-67 in Breast Carcinoma

Latha, S (2012) Histopathological Analysis, Grading and Value of Proliferation Index, Ki-67 in Breast Carcinoma. Masters thesis, Thanjavur Medical College, Thanjavur.


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INTRODUCTION: Carcinoma of the breast is the most common non-skin malignancy in women accounting for 22.9% of all cancers in women worldwide. The prognosis of women with breast cancer is currently based on the established prognostic markers particularly nodal status, tumor size, histological grade, histological subtype and rate of proliferation. As per the literature, high tumor grade and increased proliferation correlate strongly with poor prognosis. AIM OF THE STUDY: Histopathological analysis, grading and value of proliferation index, Ki-67 in breast carcinoma. METHODS AND MATERIALS: Among the 139 breast malignancies reported in the two year study period from January 2009 to December 2010, in the Department of Pathology, Thanjavur Medical College, Thanjavur, 117 breast carcinomas treated by lumpectomy or mastectomy (simple / modified radical) were alone included in the study and thoroughly analysed. Grading was done by Elston and Ellis modification of Scarff Bloom Richardson system assessing the three morphological parameters, the relative degree of tubule formation, nuclear pleomorphism and mitotic counts. In randomly selected 12 cases, Ki-67 proliferation marker was also assessed by immunohistochemical method and p63 antibody was used in intracystic papillary carcinoma to identify the presence of myoepithelial cells within the lesion and hence to assess invasiveness. RESULTS: The average incidence of breast malignancies compared to the total female malignancies was 20.09%. The peak age incidence observed was in the 5th decade (28.21%), mean age being 46 years. Infiltrating ductal carcinoma- Not otherwise specified was the most common breast malignancy (87.18%) observed. Most of the cancers were histological grade II (52.58%). Immunohistochemistry with Ki-67 proliferation marker showed progressive increase in the immunoexpression from grade I to grade III tumors. Immunohistochemistry with p63 antibody for myoepithelial cells helped to confirm the diagnosis of intracystic papillary carcinoma with focal invasion. There was statistically significant association between grade of the breast carcinoma and the clinicopathological parameters like age, tumor size and Ki-67 immunoexpression. CONCLUSION: With the adoption of objective criteria, Nottingham Grading System has shown to overcome many of the previous problems of reproducibility of grading. This grading is of particular importance for breast cancer patients in parts of the world where access to new molecular technology is not currently available. Ki-67 immuunoexpression with its strong relationship with histological grade may allow substitution of the latter to accurately predict the course of breast cancer.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Breast Carcinoma, Grading, Ki-67 immunohistochemistry.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 15 Sep 2020 03:43
Last Modified: 15 Sep 2020 13:26
URI: http://repository-tnmgrmu.ac.in/id/eprint/13160

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