Histopathology and Prognostic Indices of Carcinoma Breast with Special Reference to p53 Marker

Cancer of the breast is one of the commonest carcinomas in women, both in western world and in India. The high frequency of breast cancer in women has prompted an intensive study of possible modifiable risk factors (clinical parameters, morphological typing, and biological markers) for assessment of prognosis, prevention strategies, and treatment modalities. p53 is one of the most significant prognostic markers for breast carcinomas.

This study was undertaken to ascertain the prevalence of p53 mutated protein in breast carcinomas by immunohistochemistry and correlating the results with clinical and histological parameters and also determine its influence on axillary node metastasis.

Clinico-pathological evaluation of 50 cases of infiltrating ductal carcinoma of the breast, with reference to p53 mutated protein expression by means of immunohistochemistry was undertaken.

The percentage positivity of p53 immunohistochemistry of this study was 22% which is similar to the reported statistics of various other studies. The immunohistochemistry results also showed an equivocal p53 status in both the positive and negative cases of lymph node metastases. The carcinomas with p53 positivity demonstrated aggressive characteristics, including larger size, higher grade, in comparison with p53 negative cases. The probability of getting positive p53 status was higher for those with severe lymphocytic reaction of tumours, for patients less than 35 years of age and for those with tumour on the left side. This study clearly indicates that p53 over expression in breast cancers are mostly aggressive tumours and they confer poor prognosis and likelihood of a poor response to endocrine therapy and chemotherapy.