Is a Five Marker Panel with Basal Marker Expression (EGFR and/or CK5/6) Superior to a Three Marker Panel in Predicting Prognosis in Molecular Subtypes of Breast Carcinoma? A Comparative Study

Breast cancer is heterogeneous, as indicated by the fact that tumours with identical morphologic and immunohistochemical characteristics have different clinical behaviour and treatment responses. This cleared the door for microarray-based global gene expression profiling (GEP) and new molecular subtyping techniques for breast cancer. Among all molecular subtypes, the triple negative phenotype has been found as having the worst prognosis (TN). A 5-marker surrogate panel that includes ER-PR-HER2–negative and basal markers like epidermal growth factor receptor (EGFR) or Cytokeratin 5/6 (CK5/6) positive was used to detect basal-like breast cancer (BLBC) in this cohort. The basal-like subtype, which accounts for 15 to 20% of all breast cancers, is especially significant since it has a poor prognosis. EGFR and CK 5/6 are readily available and specific IHC surrogate basal indicators for breast cancer prognosis that can be easily added in a five-marker panel. BME is found in different molecular subtypes as well as triple negative subtypes. 106 cases of invasive breast cancer with thorough clinical and histological prognostic variables were divided into molecular phenotypes using IHC surrogate classification. Basal marker expressing (BME) tumours were characterised as those that expressed the basal markers CK5/6 and EGFR, and they were compared to tumours that expressed ER, PR, Her-2/neu, and triple negative tumours. These tumours were compared to prognostic and predictive markers for invasive breast cancer. In 50 of the 106 instances, BME was discovered. BME was also associated with tumour necrosis, lymph node metastases, and a high histological grade. In breast carcinomas, BME is an independent prognostic marker, and its expression is not limited to triple negative cases. An larger surrogate panel consisting of ER, PR, Her-2 neu, EGFR, and CK 5/6 demonstrated less prognostic relevance than three panel markers.

Author(S) Details

Pawan Trivedi
Department of Pathology, Mayo Institute of Medical Sciences, Barabanki, India.

Priyanka Singh
Department of Pathology, Mayo Institute of Medical Sciences, Barabanki, India.

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