A Study of Role of Immunohistochemical Markers in Management of Carcinoma Breast

Background: Breast carcinoma remains the most commonly diagnosed malignancy among women worldwide and a leading cause of cancer-related mortality. Immunohistochemical (IHC) markers such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) provide crucial prognostic and predictive information, enabling personalized treatment strategies. Differences in receptor expression according to menopausal status may influence disease behaviour and therapeutic outcomes. Aim and Objectives: To evaluate the expression of ER, PR, and HER2/neu in breast carcinoma and assess their association with menopausal status. The study also aimed to compare receptor expression patterns between premenopausal and postmenopausal women and determine their utility in guiding prognosis and treatment. Methodology: This prospective observational study was conducted over 22 months in the Department of General Surgery, Government General Hospital, Guntur. Sixty women with histologically confirmed breast carcinoma were enrolled and categorized into premenopausal (n=30) and postmenopausal (n=30) groups. Clinical, demographic, pathological, and reproductive data were collected using a structured proforma. Immunohistochemical analysis for ER, PR, and HER2/neu expression was performed using standardized protocols, and comparative statistical analysis was undertaken. Results: The mean age was significantly lower in premenopausal women (42.8±3.4 years) than postmenopausal women (62.1±7.6 years; p<0.001). Invasive ductal carcinoma was the predominant histological subtype in both groups (90%). ER positivity was observed in 36.7% of premenopausal and 53.3% of postmenopausal patients, while PR positivity was noted in 33.3% and 50%, respectively. HER2/neu positivity was significantly higher among premenopausal women (43.3% vs. 20%; p=0.05). Triple-negative breast cancer was identified in 20% of premenopausal and 23.3% of postmenopausal patients. Hormonal therapy eligibility was higher among postmenopausal women (50% vs. 33.3%). Conclusion: Postmenopausal women demonstrated higher ER and PR expression, indicating greater responsiveness to endocrine therapy, whereas premenopausal women exhibited increased HER2/neu positivity, suggesting more aggressive tumor biology. Routine assessment of IHC markers is essential for prognostication and individualized management of breast carcinoma.