THE HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL PROFILE OF MALIGNANT BREAST TUMORS IN NORTH-EAST ROMANIA
Abstract
Studies using gene expression profiling have identified five major subtypes of breast cancer, apart from the traditional hormone receptor positive or negative ones: luminal A, luminal B, the HER2 group, the basaloid carcinoma group and the “normal breast-like” group. Material and methods: In this retrospective study, 281 patients admitted to the Regional Institute of Oncology Iasi and the Clinical Hospital of Obstetrics and Gynecology Cuza Voda Iasi were included, for whom the oncological records, the operative protocols of the operating room, the unique register of the service were studied; the pathological anatomy and observation sheets were considered for a period of 8 years: 2015-2022. For all 281 invasive mammary carcinomas diagnosed on hematoxylin-eosin staining, they were classified into one of the corresponding histopathological types and subtypes according to WHO criteria. Results: The histopathological study allowed: 1. invasive ductal carcinoma NOS (not otherwise specified - non-specific type of invasive ductal carcinoma)-193 cases (68.68%),2. invasive lobular carcinoma-42 cases (14.94%). Immuno-labeling analysis Estrogen receptors (ER) were positive (Allred score ≥ 3) in 61% of cases (169 patients), and progesterone receptors (PR) in 64% of cases (180 patients). Ki 67 immunolabeling analysis highlighted: the presence of positivity in all cases studied, overexpression of the p53 protein in 99 cases and HER 2 immunoassays allowed the highlighting of 42 cases. Identifying cases with p53 protein mutations can select a group of patients with a higher risk of recurrence and death, and testing p53 expression in HER2 positive patients identifies the subgroup with more aggressive tumors that will benefit from a more aggressive treatment. Conclusions: The most common histological types were invasive ductal carcinoma in 90% of patients. TNM stages was as follows: stage I in 9 cases (3.2%), stage II in 88 cases (31.49%), stage III in 138 cases (48.93%), stage IV in 31 cases (11.03%) ER+/PR- phenotype were more frequent over 50years and tumors larger than 2 cm. Patients under 50 years presented twice as often HER2 positive tumors. Ki67 immunostaining seems to be associated with an unfavorable prognosis (2% of cases in the present study). p53 overexpression occurs most frequently in patients under 50 years, with tumors larger than 2 cm
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