Correlation of ER, PR and Her-2/Neu with Histological Variants of Breast Carcinoma.

Puvitha, R D (2010) Correlation of ER, PR and Her-2/Neu with Histological Variants of Breast Carcinoma. Masters thesis, Coimbatore Medical College, Coimbatore.

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Abstract

Carcinoma Afflicts All The Communities Worldwide. Breast Carcinoma Is A Major Health Concern And A Leading Cause Of Death Among Women.1 It Causes 3, 76,000 Deaths In A Year Worldwide And Every Year 9, 00,000 New Cases Are Diagnosed4. Among The Indian Women Carcinoma Of The Breast And Cervix Account For 60% Of Total Cases, Of Which Breast Carcinoma Accounts For 10.4% 1. A Study Conducted By WHO Revealed That Chennai Has The Highest Incidence Among All Leading Centres In India Accounting For 26/1, 00,000 Women 7. The Mean Age Of Occurrence Is 42 Years.3, 4 The Approach To The Management Of Breast Carcinoma Has Undergone Enormous Changes Over The Last 20 Years 13. Today, The Choice Of Conservative And Reconstructive Surgery Is More Popular Than Mastectomy. Such Changes Are Accompanied By Increasing Range Of Systemic, Hormonal And Cytotoxic Drugs Used In Both Adjuvant And Neoadjuvant Settings 6, 13. Prognosis And Management Of Breast Carcinoma Are Influenced By The Classic Variables Such As Histological Type And Grade, Tumor Size, Lymph Node Status, Estrogen, Progesterone Receptor Status And HER-2/Neu Overexpression .11 Identification Of Biomarkers Plays A Paramount Role In The Treatment, Management And Prognosis Of Breast Carcinoma. Determination Of Hormonal Status Is An Important Primary Assessment At The Time Of Diagnosis Of Breast Carcinoma. Testing For Estrogen And Progesterone Receptor Status Is Critical To Plan Optimal Treatment For Breast Cancer.1, 2 Estrogen Receptor Is A Well Established Predictive And Prognostic Factor In Breast Cancer. Patients With ER-Positive/PR-Positive Tumors Have A Better Prognosis Than Patients With Ernegative/ PR-Negative Tumors. Hormone Receptor Test Is Done Routinely In These Cases Since Hormone Treatment Has Fewer Side Effects And It Prevents Recurrence In 25% Of Cases.1 HER2/Neu Status Became Clinically Relevant With The Demonstration That HER-2/Neu Positive Tumors Have A Worse Prognosis Than HER2/Neu Negative Tumors.2 It Has Been Recognised That HER2/Neu Overexpression Served As Both A Marker Of Aggressive Disease And A Target For Treatment. HER2/Neu Status Not Only Predicts Poor Outcome, But Predicts Sensitivity To Treatment With Trastuzumab (Herceptin), A Humanized Monoclonal Anti- HER2/Neu Antibody .13, 14 With These Prognostic Implications, The Need For Accurate And Precise Assessment Of ER, PR, And HER2/Neu Expression In Breast Carcinoma Is Critical In The Determination Of Patients Appropriate For Treatment With These Drugs. Immunochemistry Is An Important Tool In Precise Histopathological Diagnosis. Immunohistochemistry (IHC) Is The Most Commonly Used Method Of Testing For ER, PR, And HER2/Neu Status.2 Survival And Response To Hormone Therapy Are Most Favourable Among Women Who Are Receptor Positive, Intermediate For Tumors Discordant On Receptor Status And Least Favourable For Receptor Negative Patients. The Interrelationship Of Estrogen, Progesterone Receptor Status And HER-2/Neu Overexpression Has An Important Role In Management Of Breast Carcinoma. It Has Been Shown That Patients With HER-2/Neu Overexpression Do Not Respond To Tamoxifen Therapy, While They Serve As A Candidates For Trastuzumab Therapy.3, 15, 18

Item Type: Thesis (Masters)
Uncontrolled Keywords: Breast Carcinoma ; ER ; PR ; Her-2/Neu ; Histological Variants.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jun 2017 01:58
Last Modified: 29 Jun 2017 01:58
URI: http://repository-tnmgrmu.ac.in/id/eprint/560

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