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Pathological parameters predicting HER-2/neu status of breast carcinoma

Author:

L Mudduwa

Department of Pathology, Faculty of Medicine, Galle, LK
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Abstract

Introduction: Immunohistochemical detection of HER-2/neu expression in breast carcinoma is a required test, yet expensive. Only 10-30% of breast cancers over-express HER-2/neu. Therefore it is important to evaluate the pathological parameters which predict HER-2/neu expression in order to select patients for HER-2/neu assessment in a poor resource setting.

Objective: To determine the positive and negative predictive values of Nottingham Grade, Nottingham Prognostic Index (NPI) and estrogen and progesterone receptor (ER and PR) status in predicting the HER-2/neu status of breast carcinoma.

Method: Seventy five consecutive invasive breast carcinomas were assessed for HER-2/neu status at the Diagnostic Immunohistochemistry Laboratory, Department of Pathology, Faculty of Medicine, Galle. Predictive values of the aforementioned four histological parameters were assessed in predicting the HER-2/neu status of breast carcinoma.

Results: Out of the 75 breast carcinomas 18 (24%) strongly expressed HER-2/neu. A Quick Score of 0 or 2 for ER gave a positive predictive value of 37% and a negative predictive value of 91% in predicting HER-2/neu status. The positive and negative predictive values of a Quick Score of 0 or 2 for PR were 32% and 86% respectively. The Nottingham grade being 2 or 3 had a positive predictive value of 26% and a negative predictive value of 91%. NPI of >3.4 had a positive predictive value of 26% and a negative predictive value 93.2%.

Conclusion: Nottingham Grade of 2 or 3, NPI of >3.4 and a Quick Score of 0 or 2 for ER and PR have a good negative predictive value in predicting the HER-2/neu status of breast carcinoma. NPI is the best parameter in this respect.

Keywords: Breast carcinoma; HER2; ER; PR; NPI; Nottingham grade.

DOI: 10.4038/jdp.v5i1.2955

Journal of Diagnostic Pathology 2006/07; 5: 13-18

How to Cite: Mudduwa, L., (2011). Pathological parameters predicting HER-2/neu status of breast carcinoma. Journal of Diagnostic Pathology. 5(1), pp.13–18. DOI: http://doi.org/10.4038/jdp.v5i1.2955
Published on 18 Apr 2011.
Peer Reviewed

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