Significance of prognostic indicators in infiltrating duct carcinoma breast: Scenario in developing country

Context: Carcinoma of the breast is one of the most common malignant tumors and is the most common cause of death from cancers in females. Early diagnosis and assessing the prognosis for each patient is essential for a better therapeutic plan and management. Aims: To evaluate the significance of various prognostic indicators of breast carcinoma by correlating with Nottingham modification of Scarff Bloom-Richardson's grading system (NMBGS). Materials and Methods: Eighty four patients who underwent mastectomy for breast carcinoma at a tertiary care centre in South India over a period of 2 years have been evaluated to note the importance of the various prognostic factors correlating them with NMBGS. Statistical Analysis: A Chi-square test was used to determine possible association between the various prognostic factors. Results: Eighty percent of the tumors were infiltrating ductal carcinoma (IDC), and it is seen that the larger tumor size, higher histopathological grade, increased lymphovascular invasion, lymphnode metastasis, tumor necrosis, microvessel density, estrogen and progesterone receptor negativity, and HER-2/neu positivity were associated with higher grade of tumor. Conclusions: The traditional morphological factors including the histological type, grade, tumor size, lymphovascular invasion, lymph node status, presence of necrosis, stromal reaction, and microvascular density (MVD) count are relatively simple but robust prognostic factors to assess, while the hormonal and genetic status not only have prognostic value but are useful predictive marker for adjuvant chemotherapy. Hence, the status of these various prognostic factors should form the basis of all routine histopathological reports in cases of breast cancer for better management.