Assessment of Immunohistochemical Expression of Fascin in Breast Carcinoma: A Cross-sectional Study

Abstract

Introduction: Fascin is an actin-binding protein that mediates invasion by modulating metastasis-associated genes. Fascin expression in breast carcinoma is correlated with clinical aggressiveness, metastasis, histological subtype and shorter disease-free survival. Aim: To evaluate fascin expression through Immunohistochemistry (IHC) and its association with clinicopathological parameters in breast cancer. Materials and Methods: This cross-sectional study was conducted in the Department of Pathology and Surgery at Pandit B. D. Sharma PGIMS, Rohtak, Haryana, India, from May 1, 2021, to April 30, 2022. A total of 80 cases of breast carcinoma were included in the study. The IHC detection of fascin expression was evaluated in relation to the molecular subtypes of breast carcinoma {luminal A, luminal B, human epidermal growth factor receptor 2 (HER2), and Triple-Negative (TN)} and other clinicopathological factors, including age, grade, tumour size, stage, regional lymph node status and survival. The collected data were categorised, compiled, tabulated, and analysed using Statistical Package for Social Sciences (SPSS) version 24.0. Associations were tested using Pearson’s Chi-square and Fisher’s exact tests. A p-value <0.05 was considered statistically significant. Results: A total of 80 breast carcinoma patients were included in the study. The patients’ ages ranged from 28 to 82 years, with a mean age of 51.5 years. The maximum number of cases, 27 (33.75%), were in the age group of 41-50 years. Fascin was positive in 50 out of 80 cases, constituting 62.5% of all cases. A statistically significant relationship was observed between fascin and the age of the patient (p-value=0.032), tumour size (p-value=0.015), histological subtype of the tumour (p-value=0.047), Estrogen receptor (ER), Progesterone Receptor (PR), HER2/neu status of the tumour (p-value <0.001 for each), and TN molecular subtype of the tumour (p-value=0.051). However, no association was observed between fascin and the side of the breast involved (p-value=0.385), histological grade (p-value=0.891), lymph node status (p-value=0.781), and Nottingham Prognostic Index (NPI) (p-value=0.329). The majority of fascin-positive cases were negative for HER2/neu 41 (82%). Conclusion: These results suggests a significant association of fascin expression with the TN subtype, with markedly increased intensity and extent of fascin expression (high score) compared to all other subtypes, indicating that fascin is a marker of the TN/basal-like subtype. This may serve as a promising candidate for targeted therapy in Triple-Negative Breast Carcinoma (TNBC). Fascin antagonists have shown promising results in some studies involving advanced TNBC that were fascin-positive. Therefore, fascin may represent a target for therapy in TNBC.

Keywords

• breast
• carcinoma
• molecular subtype