Hormonal Profile of Female Breast Cancers in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria: A 5 - year Retrospective study (January, 2009 - December, 2013)
Abstract
Background: Breast cancer is the most common cancer in females and the most common
cause of cancer death among women worldwide. Oestrogen receptor (ER), Progesterone
receptor (PR) and Human Epidermal growth factor receptor Type 2 (Her2/neu) analysis have
been accepted as established procedures in the routine management of patients with breast
cancer. This study is designed to determine the prevalence of hormonal receptors (Oestrogen
and Progesterone) and Her2/neu receptor experssion in breast cancer patients in ABUTH
Zaria, as well as to compare tumour grade with hormone and Her2/neu receptor expression.
Materials and methodos: This retrospective study was based on histologically confirmed
cases of breast cancers diagnosed in Ahmadu Bello University Teaching Hospital Zaria
within five years between January, 2009 – December, 2013. Cases were retrieved from the
departmental records and reviewed for histological typing using the 2013 WHO classification
of breast cancers, and then reviewed for Immunohistochemical staining for ER, PR and
Her2/neu, and scored using quick score. Data was analysed using SPSS version 2.0 and
results were presented in frequency distribution tables and figures.
Results: Three hundred and eighty nine cases were included for histological review while
only 348 cases fulfilled the inclusion criteria for immunohistochemistry. Of the 389 cases
analysed, the mean age of diagnosis was 44.9% with an age range of 18 to 70years.
Histologically, 94.1% were invasive ductal carcinomas of No special type (NST), malignant
phylloides constituted 1.3%, invasive lobular and medullary carcinomas accounted for 0.8%
each, while squamous cell carcinoma, invasive papillary carcinoma and stromal sarcoma
constituted 0.5% each respectively.
Of the 348 cases that were immunohistochemically analysed, 48.3% were ER positive and
43.5% and 44.0% of these were of Bloom-Richardson grades II and III respectively. PR
positivity was found in 32.0% of cases and 44.1% and 41.4% of these were of Bloom
Richardson grades II and III respectively. Her2/neu was positive in 33.6% of cases and
37.6% and 50.4% of these were of Bloom-Richardson grades II and III respectively. A
statistically significant correlation between Her2/neu receptor expression and tumour grade
was found (p=0.006) at df 12. Forty three (12.4%) of cases were triple positive while
90(26.0%) were triple negative cancers.
Ninety three cases of mastectomy specimens were analysed for Nottingham Prognostic Index
(NPI) and only 8.6% of cases had 85% 5year survival chance, whereas, 58.1% and 33.3%
had 70% and 50% 5year survival chances.
Conclusion: About half of the female breast carcinomas in Zaria are hormone receptor
positive (48.3%) and therefore amenable to treatment by hormonal manipulation.
Additionally, over a third of female breast cancer patients may benefit from targeted therapy
using Trastuzumab (Herceptin). A statistically significant correlation between Her2/neu
receptor expression and tumour grade was found. The importance of hormone and Her2/neu
receptor analysis in all female breast carcinomas in our environment cannot be
overemphasized.
