Study of Ki-67 Immunostaining in Breast Carcinoma and it’s Correlation with Grade of Tumor and Lymph Node

Abstract

Background: Breast cancer is the commonest cancer in women worldwide and represents a disease with wide spectrum particularly in terms of tumour histology, biology, prognosis and response to therapy. Breast cancer is characterized by cellular heterogeneity. Methods: The study was conducted in the Department of Pathology, GSVM Medical College, Kanpur and associated hospital of Kanpur from January 2018 to September 2019 on patients of breast carcinoma. These cases were selected from the outpatient and inpatient of LLR Hospital, Kanpur, India. In the present study, we had taken a total of 80 cases of invasive breast carcinoma as well as Histomorphology, Ki-67 immunostaining and it’s a correlation with lymph node status and tumour grade were studied. Results: This study leads us to conclude that the peak incidence of invasive breast carcinoma was reported in the age group of 41 to 50 years (with mean age 47.32 year and the standard deviation was 11.63). In the present study, the most common histological type was invasive ductal carcinoma, not otherwise specified (NOS). In our study, 66.25% of cases had metastatic lymph nodes and half of them were having more than 4 metastatic lymph node. In the grade-II of Bloom Richardson Grading system, there were 40% cases and in grade-III there were 35% of cases and grade-I has shown 25% of cases. A significant association was found between the grade of the tumor and the lymph node positivity. Conclusion: The present study concluded a positive correlation between the grade of tumour and Ki-67 immunohistochemistry, which was used as a prognostic and predictive parameter. Key-words: Bloom Richardson’s grading, Breast carcinoma, Histomorphology, Immunostaining, Invasive ductal carcinoma, Ki-67 INTRODUCTION Breast cancer is known to be a heterogeneous disease. In addition to the conventional histopathological parameters, the assessment of proliferation is one of the major factors for the treatment decisions in breast cancer patients . The incidence of breast cancer is low in India but rising. Breast cancer is the commonest cancer of urban Indian women and the second commonest in rural women. How to cite this article Singh M, Sachan S, Verma N, Omhare A, Sachan A. Study of Ki-67 Immunostaining in Breast Carcinoma and it’s Correlation with Grade of Tumor and Lymph Node. SSR Inst. Int. J. Life Sci., 2019; 5(6): 2421-2427. Access this article online https://iijls.com/ Owing to the lack of awareness of this disease and in the absence of a breast cancer screening program, the majority of breast cancers are diagnosed at a relatively advanced stage. The quality of care available for breast cancer patients varies widely according to where the patient is treated . Premalignant breast lesions are relatively common but only a small proportion appear to progress to invasive breast cancer. Most breast cancer occurs in women and the number of cases is 100 times higher in women than that in men. Breast cancer can commonly metastasize to distant organs such as the bone, liver, lung and brain. The widely used screening method is mammography for the detection of breast cancer and it reduces the mortality effectively . The mortality rate of breast cancer decreases due to the Research Article SSR Inst. Int. J. Life Sci. ISSN (O): 2581-8740 | ISSN (P): 2581-8732 Singh et al., 2019 DOI:10.21276/SSR-IIJLS.2019.5.6.2 Copyright © 2015 2019| SSR-IIJLS by Society for Scientific Research under a CC BY-NC 4.0 International License Volume 05 | Issue 06 | Page 2422 widespread early screenings and advanced medical therapies. Recently biological therapies have been proved to be beneficial for breast cancer . Ki-67 antibody reacts with a nuclear non-histone protein present in all active phases of the cell cycle except the G0 phase . Ki-67 is used as a marker of cell proliferation and used to stratify patients into good and poor prognostic categories . Those tumors, which are Ki-67 positive, are more active in growth, more aggressive in the invasion, and more metastatic . MATERIALS AND METHODS This study was done in the Department of Pathology, G.S.V.M. Medical College Kanpur, India from January 2018 to August 2019. Total of 80 female patients were included in the study. We included in our study histomorphology and lymph node status in breast carcinomas, and Ki-67 immunostaining in all these breast carcinomas and its prognostic importance. Tumor mass was subjected to Immunohistochemistry (IHC). The above study was approved by the Ethical Committee and informed consent was obtained from the patients before the study. The modified Bloom-Richardson Histopathological grading [8] was used in this present study. Inclusion criteria 1. Mastectomy specimens of clinically/cytologically diagnosed breast malignancy in the female of all age group 2. Patients, who gave written informed consent Exclusion criteria 1. Patients with metastatic malignancy of the breast 2. Patients already treated for contra-lateral breast cancer