A10: Pattern of expression of ER/PR in 534 invasive breast cancer cases and rate of recurrence and disease progression in 211 invasive breast cancer cases who are on treatment based on traditional prognostic factors in Addis Ababa University Teaching Hospital , Addis Ababa, Ethiopia , East Africa, 2011 2013
1Addis Ababa University, Addis Ababa, Ethiopia
This retrospective study reviewed the patterns of expression of ER( estrogen receptor)/ PR( progestron receptor) in 543 invasive breast cancer cases to examine prognostic roles of ER and PR and rate of disease progression and recurrence in 211 cases who are on treatment based on conventional prognostic factors seen during the period of January 2011 to December 2013 at department of Oncology , Medical faculty , Addis Ababa University , Addis Ababa , Ethiopia. Assessment of the usual suggested risk factors for breast cancer is also done. Findings are compared with reports from both developed and developing nations.
Data of 543 cases of breast cancer with ER / PR determination were retrieved from register of department of Pathology for the period of January 2011 to December 2013.Immunostain done on FNAC and surgical biopsy specimens were retrieved and reevaluated.
Of 543 cases medical record of 211 cases was revised to get demographic data , history of risk factor, course of disease with treatment , ER/PR result , histologic type, tumor stage and treatment modalities used.
Analysis of ER/PR expression was done on all 543 cases, the expression pattern and treatment response to the prevailing modalities was analyzed using SPSS 16.0 version.
Based on analysis of the 543 cases , no marked difference in expression pattern of ER and PR below 40 and above 40 years of age was observed , 72.3% and 73.8% for ER and 41.9% and 40.0 % for PR respectively. Male breast cancer showed higher positivity rate of expression (86% for ER and 62 % for PR) as compared with female ( 72% for ER and 60% for PR).
Based on analysis of the 211 cases , highest ER expression was seen on well differentiated invasive ductal carcinoma and highest PR expression was on poorly differentiated invasive ductal carcinoma. Disease progression was seen in a slightly higher percentage with male breast cancer (54.5%) than female(52.2%) and its rate increases as stage of the disease increases , with lymph node involvement , with positive surgical margins and in ER/PR negative cancers than positives. No relation was observed between treatment modality used and disease progression. Higher recurrence rates are observed in ER or PR negatives than ER or PR positives, with lymph node involvement, with male breast cancer, with increasing stage of tumor and with invasive lobular carcinomas.
History of hormonal contraceptive use in female breast cancer cases was 46.4%.
The finding of this study calls for more intense studies to evaluate traditional prognostic factors on large sample size with addition of bcl-2 expression so that meaningful , targeted and cost effective therapeutic interventions can be planned and executed.