The Predictive and Prognostic behavior of Breast Cancer by NACT in Relation to Tumor Grade, ER/PR and Her- 2/neu Expression- Study in a Tertiary Care Hospital of Eastern India

Abstract

Introduction: Neo-adjuvant chemotherapy (NACT) is considered as initial management of all patients with locally advanced breast cancers and followed by surgery. NACT enables reduction of breast tumor sizethereby prolonging survival and altered the expression of steroid receptor (ER/PR) and Her-2/NEU in the cancer cells. Our aims and objective was to look into the association of patient age, tumor grade, expression status of ER/ PR / Her-2/neu receptor status before and after NACT in Indian women patients. Material and methods: The study was conducted over a period of 4 years. Hormone receptor and Her-2/neu status was determined by IHC over 412 samples. The patients receiving NACT and having both core needle biopsy and surgery (MRM) are considered as NACT group. The other group did not receive NACT but have core needle biopsy and surgery are taken as non NACT group. The discordance was compared between these two groups. Results: Patients of more than 40years of age had predominantly favorable hormone receptor status expression. In the NACT group favorable receptor status was 60.35% and discordance was higher in ER, PR and HER2/neu in comparison to non-NACT group. Conclusions: Significant alteration of hormone receptors and Her-2/neu expression was found in biopsy of the patients receiving NACT. So reevaluation of the hormonal status and Her 2 neu receptor in residual invasive carcinoma may be considered as it has advantage on chemotherapy after final surgery.