Association of Expression Patterns of ER, PR, HER-2/neu and Ki67 with Nottingham Tumor Grade in Breast Cancer Biopsies

ER, PR, HER2 and Ki-67 in Relation to Nottingham Tumor Grade in Breast Cancer

Abstract

Objective: To examine the association of expression patterns of ER, PR, HER-2/neu, and Ki-67 with Nottingham tumor grade in breast cancer biopsies. Methodology: This was a cross-sectional study, which included 876 histologically confirmed breast carcinoma cases at Meezan Lab, Faisalabad, from January 2020 to December 2024. The Nottingham (modified Scarff-Bloom-Richardson) grading system was used to grade tumors. ER, PR, HER-2/neu, and Ki-67 were all subjected to immunohistochemistry. Pearson correlation and chi-square tests were performed, with p-values <0.05 considered statistically significant.

Results: The majority of patients were in the 40–50-year age range. The most frequent histological subtype was invasive ductal carcinoma (91.2%), and the most common tumors were Grade II (50.7%), followed by Grade III tumors (48.7%). The positivity rates of ER and PR were 50.9% and 35.5%, respectively, while that of HER-2/neu was 51.6%. A high Ki-67 proliferation index was mostly found in higher-grade (grade III) tumors. Nottingham grade had a significant positive association with ER (p<0.001), PR (p<0.001), HER-2/neu (p=0.013), and Ki-67 (p<0.001). Ki-67 had the strongest association with tumor grade.
KEYWORDS: Breast cancer; Estrogen receptor; HER-2/neu; Immunohistochemistry; Ki-67; Nottingham grade; Progesterone receptor