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Knowing the tumour biology can help to stratify patients for prognostic and therapeutic purposes. Expression of estrogen and progesterone receptors (ER, PR), amplification of human epidermal growth factor receptor 2 (Her 2 neu), size and histological grading of tumour , axillary lymph node state and NPI ( Nottingham Prognostic Index) are well established parameters that have influence on prognosis and treatment of breast carcinoma. It is an institutional based retrospective cross sectional analytic study.181 female patients who underwent primary mastectomy and axillary clearance for invasive ductal carcinoma of breast in Teaching Hospital Jaffna from 2014 to 2018 were included in this study.ER/PR status and amplification of Her 2 neu in the infiltrating ductal carcinoma of breast and the prognostic indices were recorded. SPSS was used for statistical analysis and correlation between the receptor status and prognostic indices were calculated using Spearman’s correlation, chi-square and Kruskal- Wallis tests. Of the 181 patients with invasive ductal carcinoma of breast, 132 patients (72.9%) were above 45 years old. A total of 87 patients had ER + (48.1%), 76 had PR + (41.9%) and, 62 had Her 2-neu + (34.3%). The mean ages of patients with expression of ER, PR and Her 2-neu amplification were 56.43, 54.36 and 52.95 years respectively. Triple negative tumour was found in 38 patients (21%). NPI 1 indicating good prognosis, NPI 2 with moderate and NPI 3 with poor prognostic categories were seen in 57 (31.5%), 74 (40.9%) and 50 (27.6%) patients respectively. Stage T2 sized tumour was identified in 88 patients (48.6%).A total of 110 patients (60.8%) had grade 2 tumours. 89 patients (49.1%) had axillary lymph node involvement. Statistically significant correlation was found between the expression of ER and PR (Spearman’s correlation coefficient (r) = 0.136, p value < 0.0001). Statistically significant inverse correlation existed between the expression of hormone receptors (ER&PR) and Her 2-neu amplification (chi square=12.93, p value < 0.0001). Kruskal-Wallis test revealed statistically significant association between the expression of ER and the favourable NPI groups and also with low grade tumours ((p value 0.046 and 0.006) and a statistically significant association between Her2-nue amplification and axillary lymph node involvement (p value = 0.0001).

jaffna medical journal

Hormone receptor status, Her 2- neu amplification and their correlation with prognostic indices in patients with invasive ductal carcinoma of breast in Jaffna