Histopathological characteristics of female breast carcinomas seen at the University of Port Harcourt Teaching Hospital, Port Harcourt Nigeria.

Abstract

BACKGROUND: Breast carcinoma is an unpredictable disease in the sense that some patients may present with relatively early disease and die of widespread metastases within six months to one year, while others present with fairy advanced disease and yet survive longer. The aim of this study was to characterize breast carcinomas into prognostic groups using histological features. METHODOLOGY: A total of 269 breast carcinomas in females received during a five-year period (January 1991 to December 1995 inclusive) were analyzed. Archive records (request forms and microscopic slides) of all breast malignancies diagnosed in the department of Anatomical Pathology of University of Port Harcourt Teaching Hospital were retrieved and evaluated with respect to histological type, histological grades, and mononuclear cell infiltration within the primary tumour. The modified Bloom-Richardson system of microscopic grading of breast carcinoma was used. RESULTS: The majority of carcinomas showed scanty or absent tubule formation (43.1%) and 59% of cases showed numerous mitotic figures. Forty-nine percent of carcinomas show poorly differentiated or anaplastic nuclei. The final tumour grade (FG) which is the summation of tubular pattern, nuclear pleomorphism and mitotic grades of each of the tumours reveals that 53% fall in FG3, 26% in FG2while only 21% fall in FG1. The majority of the breast carcinomas in this study, 58%, show scanty or absent mononuclear infiltration. CONCLUSION: The majority of breast carcinomas in this study are poorly differentiated invasive ductal carcinoma, "not otherwise specified" which exhibit high proliferation ratio and are associated with poor host cellular immune reaction. These attributes translate to poor prognosis.