Dr Shumna Akhter Azad, Assistant Registrar, Department of Surgical Oncology, National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2024 Oct;33(4):1204-1210.
Breast cancer is the most common type of cancer among women. The molecular subtypes of breast cancer, depending on the Estrogen Receptor (ER), Progesterone Receptor (PR) and Human Epidermal Growth Factor Receptor (HER-2) status, usually play a vital role for the adjuvant treatment. Interestingly, there is a good possibility of change of receptor status in the recurrence of same primary tumor. The study is designed April 2018 to March 2019 to see the concordance in triple-receptor expression (ER, PR, and HER-2) between the primary and the locally recurrent breast cancer patient and the results can be able to influence the management and prognosis of the breast cancer patients. This observational study was carried out in the department of surgical oncology, NICRH where total 48 patients were studied who were subjected to core biopsy of recurrent lesion for ER, PR and HER-2 status. A structured case record form was used to interview and collect data. Data analysis was done using SPSS version 26.0 to see concordance and discordance in triple-receptor expression between the primary and the locally recurrent breast cancer patient. Among 48 cases, 12(25.0%), 10(20.83%) and 2(4.16%) patients showed Estrogen Receptor (ER), Progesterone Receptor (PR) and Human Epidermal Growth Factor Receptor (Her-2) discordance that are statistically significant in every receptor status. Majority discordance of ER, PR and Her-2 were associated with invasive duct cell carcinoma (IDC); ER & Her-2 discordance was equally associated with histological grade 2 and 3 whereas PR discordance had significant association with grade 3. Staging of disease showed that all ER, PR and Her-2 discordance were associated with stage (p<0.05). Besides, majority discordance was mostly associated with lumpectomy except Her-2 discordance. Besides, among the adjuvant treatment regimen chemotherapy along with radiotherapy was mostly associated with discordance of all receptors (p<0.05). Estrogen Receptor (ER), Progesterone Receptor (PR) and Human Epidermal Growth Factor Receptor (HER-2) status of primary breast cancer showed 25.0%, 20.83% and 4.16% discordant in recurrent episodes in this study. Invasive duct cell carcinoma, histological grade 2 and 3, stage II, stage III, MRM and CT along with RT are major attributable factors in this study.
乳腺癌是女性中最常见的癌症类型。乳腺癌的分子亚型，根据雌激素受体 (ER)、孕激素受体 (PR) 和人表皮生长因子受体 (HER-2) 的状态，通常对辅助治疗起着至关重要的作用。有趣的是，同一原发性肿瘤复发时受体状态发生变化的可能性很大。本研究设计于 2018 年 4 月至 2019 年 3 月，旨在观察原发性和局部复发性乳腺癌患者三受体表达（ER、PR 和 HER-2）之间的一致性，研究结果可能影响乳腺癌患者的管理和预后。这项观察性研究在 NICRH 外科肿瘤学系进行，共对 48 例接受局部复发性病变核心活检以确定 ER、PR 和 HER-2 状态的患者进行了研究。使用结构化病例记录表格对患者进行访谈和收集数据。使用 SPSS 版本 26.0 进行数据分析，以观察原发性和局部复发性乳腺癌患者三受体表达的一致性和差异性。在 48 例患者中，12 例（25.0%）、10 例（20.83%）和 2 例（4.16%）患者的雌激素受体 (ER)、孕激素受体 (PR) 和人表皮生长因子受体 (Her-2) 表达存在差异，在每个受体状态下均具有统计学意义。ER、PR 和 Her-2 的大多数差异与浸润性导管细胞癌 (IDC) 有关；ER 和 Her-2 的差异与组织学分级 2 和 3 相等，而 PR 的差异与分级 3 有显著关联。疾病分期显示，所有 ER、PR 和 Her-2 的差异均与分期相关（p<0.05）。此外，大多数差异主要与保乳术有关，除了 Her-2 差异。此外，在辅助治疗方案中，化疗联合放疗与所有受体的差异最相关（p<0.05）。本研究中，原发性乳腺癌的雌激素受体 (ER)、孕激素受体 (PR) 和人表皮生长因子受体 (HER-2) 状态在复发时分别有 25.0%、20.83%和 4.16%出现不一致。在本研究中，浸润性导管细胞癌、组织学分级 2 和 3、II 期、III 期、MRM 和 CT 联合 RT 是主要的归因因素。
