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IHC Panel With Reporting- Breast I

Cancer
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Report in 288Hrs

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At Home

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No Fasting Required

Details

Tumor immunohistochemistry panels.

₹4,292₹6,131

30% OFF

IHC Panel With Reporting- Breast I

  • Why is it done?
    • Immunohistochemistry (IHC) panel for breast cancer involves testing tissue samples to identify specific protein markers that help classify breast tumors and guide treatment decisions
    • Determines hormone receptor status (estrogen receptor [ER] and progesterone receptor [PR] expression) to assess eligibility for endocrine therapy
    • Evaluates HER2/neu (human epidermal growth factor receptor 2) expression to identify patients who may benefit from HER2-targeted therapies
    • Assesses Ki-67 proliferation index to evaluate tumor aggressiveness and guide prognosis
    • Performed on newly diagnosed invasive breast cancer to establish molecular subtype (Luminal A, Luminal B, HER2-enriched, or Triple-Negative)
    • Used to confirm or clarify diagnosis of breast cancer when morphology alone is insufficient
  • Normal Range
    • Estrogen Receptor (ER): Negative (<1% of tumor nuclei staining) is normal for non-hormonally responsive tissue; Positive (≥1% of tumor nuclei staining) indicates hormone-responsive tumor
    • Progesterone Receptor (PR): Negative (<1% of tumor nuclei staining) is normal; Positive (≥1% of tumor nuclei staining) indicates hormone-responsive tumor
    • HER2/neu: Negative (Score 0-1+) is normal; Equivocal (Score 2+) requires FISH testing for confirmation; Positive (Score 3+) indicates HER2 overexpression
    • Ki-67 Proliferation Index: Expressed as percentage of positive nuclei; Low (<10%) suggests lower proliferation rate; Intermediate (10-20%) indicates moderate proliferation; High (>20%) suggests aggressive tumor behavior
    • Normal tissue typically does not have significant staining for these markers, but benign lesions may show variable reactivity
  • Interpretation
    • ER/PR Positive (ER+ and/or PR+): Indicates Luminal subtype breast cancer; tumor growth is hormone-dependent; patient is candidate for endocrine therapy (tamoxifen, aromatase inhibitors); generally associated with better initial prognosis but may develop endocrine resistance
    • ER/PR Negative (ER- and PR-): Tumor is not hormone-responsive; endocrine therapy will not be effective; if also HER2-negative, classified as Triple-Negative breast cancer; typically requires chemotherapy as primary treatment
    • HER2 Positive (3+ or 2+ with FISH amplification): Indicates HER2-enriched or Luminal B subtype; patient is candidate for HER2-targeted therapies (trastuzumab, pertuzumab, T-DM1); associated with more aggressive tumor behavior; improved outcomes with targeted therapy
    • HER2 Equivocal (2+ by IHC): Requires reflex testing with FISH or alternative methods (HER2 gene copy number analysis) for definitive classification before treatment decisions
    • Ki-67 High (>20%): Suggests rapid cell proliferation and more aggressive behavior; indicates higher risk of recurrence; may warrant more intensive treatment; helps distinguish Luminal A from Luminal B subtype when combined with ER/PR status
    • Triple-Negative (ER-, PR-, HER2-): Most aggressive subtype with limited targeted therapy options; treatment primarily chemotherapy-based; may be eligible for immunotherapy (PD-L1 testing); generally associated with poorer prognosis
    • Specimen quality, fixation time, and antigen retrieval methods may affect staining intensity and interpretation; immunohistochemical scoring is semi-quantitative and subject to observer variation
  • Associated Organs
    • Primary Organ: Breast tissue (mammary gland)
    • Invasive Breast Carcinoma: Most common indication; IHC panel aids in diagnosis, prognosis, and treatment planning
    • Ductal Carcinoma In Situ (DCIS): May be tested to assess risk of progression and guide endocrine or radiation therapy decisions
    • Metastatic Disease: Can affect lymph nodes, bone, liver, lungs, and brain; IHC panel helps confirm metastatic breast cancer and assess for discordance from primary tumor
    • Potential Complications from Abnormal Results: Triple-negative cancers carry higher risk of visceral and brain metastases; HER2-positive tumors at increased risk of cardiac toxicity with targeted therapy; inadequate hormone or HER2 receptor expression may lead to treatment failure if not properly identified
    • Lymph Node Assessment: IHC helps identify micrometastases and isolated tumor cells in lymph nodes using cytokeratin staining
  • Follow-up Tests
    • FISH (Fluorescence In Situ Hybridization): Recommended for HER2 equivocal (2+) IHC results or when HER2 status is critical for treatment decisions; provides definitive HER2 amplification status
    • PD-L1 Testing: Recommended for triple-negative breast cancer to assess eligibility for immunotherapy with checkpoint inhibitors
    • Genetic Testing (BRCA1/BRCA2): May be offered to patients with triple-negative breast cancer, particularly if age <50 years; helps identify hereditary cancer risk
    • Multigene Panel Testing (Oncotype DX, MammaPrint): May be performed on ER/PR-positive tumors to refine risk stratification and guide chemotherapy decisions independent of HER2 status
    • Staging Imaging: CT chest/abdomen/pelvis, bone scan, or PET-CT imaging may be recommended for high-risk tumors to evaluate for metastatic disease
    • HER2 Gene Copy Number Analysis (Digital PCR or NGS): Alternative confirmatory method for HER2 status when FISH is inconclusive or unavailable
    • Clinical Follow-up: Regular imaging and laboratory studies based on treatment type; ER+ patients may require long-term endocrine therapy monitoring; HER2+ patients require cardiac assessment before and during trastuzumab therapy
  • Fasting Required?
    • Fasting: No
    • This is a tissue-based test performed on biopsy or surgical specimens, not a blood test; therefore, fasting is not required for the patient
    • Specimen Collection: Breast tissue obtained via core needle biopsy, excisional biopsy, or surgical resection; specimen must be fixed in formalin (standard 10% neutral-buffered formalin) within 1 hour of collection
    • Patient Preparation: Standard biopsy preparation applies (local anesthesia for core biopsy); patient may require pre-procedure imaging for localization; post-biopsy wound care instructions should be followed
    • Medications: No specific medications need to be avoided for IHC testing; continue all regular medications unless specifically instructed otherwise by the procedure team
    • Anticoagulation: Aspirin and anticoagulants should be managed per institutional biopsy protocols; may be continued or held depending on bleeding risk assessment

How our test process works!

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