Immunohistochemical Expression of Alpha Smooth Muscle Actin in Infiltrating Ductal Carcinoma of Breast and its Association with Histopathological and Hormonal Status: A Cross-sectional Study
Published: April 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/62952.17791
Vajja Nagaraju, Shilpa Mannigatta Doddagowda, Supreetha Megalamanne Sunanda, Hemalatha Annantharamaiah, Kalyani Raju, Patrapalle Nadipanna Sreeramulu
1. Postgraduate Student, Department of Pathology, Sri Devaraj Urs Medical College Affiliated to Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
2. Associate Professor, Department of Pathology, Sri Devaraj Urs Medical College Affiliated to Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
3. Associate Professor, Department of Pathology, Sri Devaraj Urs Medical College Affiliated to Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
4. Professor, Department of Pathology, Sri Devaraj Urs Medical College Affiliated to Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
5. Professor and Head, Department of Pathology, Sri Devaraj Urs Medical College Affiliated to Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
6. Professor, Department of Surgery, Sri Devaraj Urs Medical College Affiliated to Sri Devaraj Urs Academy of Highe
Correspondence
Dr. Shilpa Mannigatta Doddagowda,
Associate Professor, Department of Pathology, Sri Devaraj Urs Medical College Affiliated to Sri Devaraj Urs Academy of Higher Education and Research, Kolar-563101, Karnataka, India.
E-mail: mdshilpa@gmail.com
Introduction: Breast carcinoma is the second most common cancer and cause of death worldwide, with a mortality rate of 15%. Among various theories regarding the pathogenesis of cancer, the tumour microenvironment is known to play an essential role in cancer development and progression.
Aim: To determine the expression of alpha Smooth Muscle Actin (α-SMA) in infiltrating ductal carcinoma of breast carcinoma and its association with histopathological parameters and hormonal receptors status.
Materials and Methods: This was a cross-sectional observational study done in Department of Pathology, RL Jalappa Hospital, a tertiary care centre, Karnataka, India from January 2018 to December 2022. A total of 100 cases of Infiltrating Ductal Carcinoma confirmed by histopathological examination were included in the study. All the Haematoxylin and Eosin (H&E)-stained slides were screened for histological type, tumour grade, and nodal metastasis and Immunohistochemistry (IHC) markers like Oestrogen Receptor (ER), Progestrone Receptor (PR), Ki67, Human Epidermal growth factor 2 neu (HER2/neu) and α-SMA were performed. The p-value (Probability that the result is accurate) of <0.05 was considered stastically significant after assuming all the rules of stastistical tests.
Results: The majority (33%) of the subjects belonged to the age group 51-60 years. 54% of the subjects were positive for ER, 52% of the subject was positive for PR, and 30% of the subjects were HER2/neu. 53% of the subjects had >14% Ki67 and 47% of the subjects had <14% Ki67. According to molecular typing, 38% was luminal A, 20% was luminal B, Triple-Negative Breast Cancer (TNBC) was present in 30%, and HER2/neu positivity was seen in 12%. According to Nottingham Prognostics Index (NPI), patients were grouped into four categories according to the NPI score: I (excellent) was 15%; II (good) was 36%, III (moderate) was 32%; and IV (poor) was 17%.
Conclusion: SMA positivity can be used as an important prognostic factor in infiltrating ductal carcinoma as its stromal expression is associated with grade of the tumour and lymph node status.
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