Breast cancer in 2020: Does receptor status still drive the cancer as before – An Indian study

Abstract

Background: Incidence of breast cancer has increased globally over the past several decades with the greatest increase in the Asian countries. The hormone status perhaps plays the most vital part in disease discordance and impacts the clinical behavior of the disease. This study attempts to study the receptor status in carcinoma breast in the Indian Population and study any change in its correlation with the clinical profile, tumor characteristics, and metastatic profile. Methods: This was a prospective observational study done on all patients with breast cancer treated at Command Hospital Airforce, Bangalore, between January 2017 and December 2019. Two hundred and eight female patients with breast carcinoma were included in the study. Results: Estrogen (ER) and progesterone receptors (PR) are found positive in only 20%–45% of Indian patients. ER-positive rates are lower in Indian patients than those in Western countries. Triple-negative breast cancer (TNBC) metastasizes especially to the liver and lung; however, Her 2nu-positive tumors present as Stage III rarely metastasize. Hormone-positive tumor showed a bimodal peak pattern, while TNBC is seen uniformly in all age groups now. BIRADS 5 was seen exclusively in triple-positive disease. Grade I tumors are exclusively seen in hormone-positive tumors, but 25% of these tumors present with distant metastasis and 90% with node-positive disease. Conclusion: Breast cancer patients of Indian origin tend to be younger; tumors are often large when rst diagnosed, and of a high grade as compared to Western countries. The hormone receptor status still determines and drives the disease; however, there is a major paradigm shift in the disease behavior now as compared to the earlier data. The biology of the disease and the clinicoepidemiological profile of breast cancer in relation to the receptor status is an ever-evolving event and periodic evaluation of their correlation is the need of the hour. This will improve the further understanding of the disease, help in therapeutics, and improve outcomes in such patients

Keywords

• breast carcinoma
• epidemiology
• receptor status