Association of carcinoma breast: grade and estrogen progesterone receptor expression

To determine the association between histological grade of tumour and estrogen progesterone receptors (ER/PR) expression in unselected invasive carcinoma of breast in Malaysian patients.

An observational study.

Advanced Medical and Dental Institute and Hospital, Kepala Batas, from year 2002 to 2007.

Ethical approval from Ministry of Health of Malaysia was obtained. Retrospective case records of patients presented between 2002- 2007 were reviewed for obtaining information on grade of tumour and expression of ER/PR in unselected carcinoma of breast patients. Records with missing data were discarded.

Out of 195 cases evaluated, 42 cases of grade-I tumour were recorded of which 08 (19%) tested positive for ER and 34 (81%) tested negative, 86 cases represented grade-II tumour of which 33 (38%) tested positive for ER and 53 (62%) were negative for ER, while out of 67 grade-III tumours 22 (33%) were positive for ER receptors while 45 (67%) were negative, (chi2 statistic (df) 4.831, p=0.089). For PR, 192 cases were evaluated and data was missing for 3 cases on PR status. Grade-I tumour consisted of 39 cases of which PR +ve represented 07 (17.94%) and 32 (82.05) cases PR -ve; 86 cases were of grade-II of which 31 (36.04%) were PR +ve and 55 (63.95%) PR -ve. Sixty seven cases of grade-III tumour of which 19 (28.35%) were PR +ve and 48 (71.64) were PR -ve (chi2 statistic (df): 4.297; p=0.117).

ER/PR positivity trend was highest for grade-II tumours compared to grade-I and grade-III tumours. In general ER positivity was more with grade-II and grade-III tumours compared to grade I tumours. Although results did not reach statistical significance but there was a trend towards ER/PR positivity in grade-II and III tumours. So far, studies from South East Asia reported ER/PR expression more with low grade tumours.