Immunohistochemical Expression of BRCA1 Protein, ER, PR and Her2/neu in Breast Cancer: A Clinicopathological Study.

Breast cancer is a heterogeneous hormone-dependent disease. Potential prognosis depends on the clinicopathological evaluation and assessment of other prognostic indicators. The detection of the oestrogen Receptor (ER), Progesterone Receptor (PR), Human epidermal growth factor receptor 2 (Her2/neu) and BRCA1 oncoprotein is pivotal for prognostic evaluation and to choose the appropriate post-surgical adjuvant therapy beside selecting the proper candidate for genetic counselling. OBJECTIVES: To detect the immunoexpression of the BRCA1 oncoprotein in mammary invasive ducal carcinoma and its association with the prognostic markers (ER, PR and Her2/neu hormonal receptors) and other clinicopathological parameters to improve the patients' treatment plans. METHODS: A cross-sectional study design including 83 paraffin blocks and histological slides collected from Al-Jumhoori Medical City Teaching Hospital Laboratory in Mosul and the Central Public Health Laboratory in Baghdad between the 1st of January 2010 to the 13th of March 2012 for patients diagnosed with primary invasive ductal breast carcinomas. Immunohistochemistry (IHC) using monoclonal antibodies against ER, PR, Her2/neu receptors and BRCA1 protein was performed via the fully automated immunostaining instrument 'Ventana Benchmark'. RESULTS: BRCA1 protein immunoexpression was detected in 20.5% of cases. It was significantly high with increasing tumour grade and stage. Although there was a trend of BRCA1 negativity toward negative ER, PR and Her2 receptors, no significant associations were observed with any of these parameters and the patients' age. CONCLUSION: Altered BRCA1 expression is significantly associated with advanced tumour grade and stage. High number of cases with negative BRCA1 expression showed negative ER, PR and Her2/neu expression.

Proliferative Index (Ki67) for Prediction in Breast Duct Carcinomas

Background and objectives: To date, many tumor markers have been used to predict prognosis and therapeutic response in patients with breast cancer. The well established and routinely applied tumor markers are the estrogen-receptor, progesterone-receptor and Her2/neu-receptor. In the current study, we aimed to highlight any association of the proliferation index (Ki67) in breast infiltrative duct carcinoma with the tumor grade, tumor size and nodal status in addition to hormone receptor status. Tissue sections were stained immunohistochemically for Ki67 nuclear antigen, estrogen, progesterone and Her2/neu receptors using an automated Dako machine (Dako Denmark. There was a significant inverse relationship of Ki67 levels with ER and PR, while values were directly proportional to the tumor grade and Her2/neu status. No significant association was found between Ki67 and size of tumor or nodal status. Ki67 immunoexpression may offer an independent predictive tumor marker and for routine application in cases of breast cancer.