Evaluation of Clinical and Histopathological Prognostic Markers of the Breast Carcinoma

Background: Breast carcinoma is one of the leading causes of cancer-related morbidity and mortality worldwide. According to GLOBOCAN 2022, it ranks second in incidence and fourth in mortality among all cancers globally, and it is the most common malignancy among women in India. Histopathological parameters remain fundamental prognostic indicators in routine diagnostic practice, particularly in resource-limited settings where advanced molecular testing may not be readily accessible.

Aim: To evaluate the clinical and histopathological prognostic markers of breast carcinoma in operable cases received at a tertiary care center.

Material and Methods: This retrospective, observational, descriptive cross-sectional study included 50 cases of operable breast carcinoma received as lumpectomy or mastectomy specimens in the Department of Pathology at P.D.U. Medical College, Rajkot, from January 2022 to December 2025. Trucut biopsies, wedge biopsies, mesenchymal and hematolymphoidtumours, metastatic tumours, and cases treated with neoadjuvant therapy were excluded. Clinical parameters including age, gender, laterality, tumour location, and tumour size were recorded. Histopathological parameters such as tumour grade (Nottingham modification of Bloom–Richardson system), tumour stage (pT), lymphovascular invasion, perineural invasion, necrosis, and lymph node metastasis were assessed using routine Hematoxylin and Eosin staining.

Results: The age of patients ranged from 32 to 78 years, with the majority in the fourth (48%) and fifth (40%) decades. All cases were females. Left breast involvement (54%) was slightly more common than right (46%). The subareolar region was the most frequent tumour location (50%). Tumour size ranged from 1.2 to 9.8 cm, with most tumours (54%) measuring 2–5 cm. Histologically, Grade 2 tumours were most common (48%), followed by Grade 3 (42%). The majority of cases were pT2 stage (48%). Lymphovascular invasion was observed in 38% of cases, perineural invasion in 22%, necrosis in 60% (including 24% with comedo necrosis), and lymph node metastasis in 66% of cases. High-grade tumours showed a greater association with lymph node metastasis and other adverse prognostic factors.

Conclusion: Histopathological parameters such as tumour grade, stage, lymphovascular invasion, perineural invasion, necrosis, and lymph node metastasis remain crucial prognostic indicators in breast carcinoma. Grade 2 tumours were most prevalent; however, higher-grade tumours demonstrated a stronger association with lymph node metastasis and poor prognostic features. In resource- constrained settings, meticulous histopathological evaluation continues to play a pivotal role in guiding management and predicting outcomes.