Steroid receptor status and its clinicopathological correlation in post-menopausal breast cancer patients of Kumaon region of Uttarakhand

Abstract

Background: Estrogen receptor (ER) and progesterone receptor (PR) status has been used since the mid-1970s in the management of breast cancer as an indicator of endocrine responsiveness and as a prognostic factor for early recurrence.

Aim: To study the steroid receptor profile and its clinico-pathological correlation in post-menopausal breast cancer patients.

Setting and design: A retrospective and prospective analysis of 80 and 68 patients, respectively, was undertaken to study the prevalence of ER and PR in post-menopausal breast cancer patients. The result of collective observations was analyzed statistically.

Material and methods: In this study, retrospective data on hormonal receptor status of 80 post-menopausal breast cancer patients and prospective data of 68 patients were collected and analyzed.

Statistical analysis used: Student "t" test, Chi-square test.

Results: Receptor positivity was high in higher age group but unlike earlier studies the receptor positivity was lower in incidence. The study showed an incidence of 37.83% receptor positive tumors in post-menopausal women. ER was positive in 27.03% patients of whom 16.2% were also PR positive, while the remaining patients were ER/PR negative. ER was negative in 72.47% patients of whom PR was positive in 10.8% and negative in the remaining. Out of 148 cases, 128 (86.48%) had palpable axillary lymph nodes. Out of 148 patients, 36 (24.34%) had supraclavicular lymph node involvement (Chi-square = 1.70, P = 0.193). Out of 148 cases, 144 (92.29%) were infiltration ductal carcinomas. Grade I tumors were more common in receptor positive tumors while grade II and III tumors were more common in receptor negative tumors. Receptor negative tumors were more aggressive in terms of peau de' orange, ulceration, fungation and chest wall invasion. Metastases and axillary lymph node involvement was observed more in receptor negative tumors; however, supraclavicular lymph node involvement was equal in both the groups. Infiltrating ductal carcinoma was the most common type of carcinoma in both the groups.

Conclusion: The receptor positivity of steroid receptors was more in higher age groups, but the incidence of receptor positivity was lower than that reported in earlier studies. No statistically significant association was found between receptor status and clinical presentation of breast cancer, histopathological status of tumor and metastases.