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IHC Panel With Reporting Breast II

Cancer
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Report in 288Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Tumor immunohistochemistry panels.

₹5,328₹7,611

30% OFF

IHC Panel With Reporting Breast II

  • Why is it done?
    • Characterizes breast cancer tumors using immunohistochemistry (IHC) to detect specific protein markers and receptor status on cancer cells
    • Determines hormone receptor status (Estrogen Receptor [ER] and Progesterone Receptor [PR]) to predict treatment response
    • Evaluates HER2/neu protein expression to identify patients eligible for targeted HER2-directed therapies such as trastuzumab (Herceptin)
    • Assesses Ki-67 proliferation index to determine tumor growth rate and prognosis
    • Guides treatment planning and selection of chemotherapy, hormone therapy, or targeted immunotherapy
    • Classifies breast cancer subtypes (luminal A, luminal B, HER2-enriched, triple-negative) for prognostic stratification
    • Typically performed on newly diagnosed invasive breast cancers at the time of initial pathologic evaluation
  • Normal Range
    • Estrogen Receptor (ER): Negative (0%) or Positive (≥1% nuclear staining); scores reported as 0-3+ or H-score 0-300
    • Progesterone Receptor (PR): Negative (0%) or Positive (≥1% nuclear staining); scoring same as ER
    • HER2/neu: Negative (0-1+), Equivocal (2+), or Positive (3+); 2+ results typically require FISH/CISH confirmation
    • Ki-67 Proliferation Index: Percentage of cells showing nuclear staining; typically reported as low (<14%), intermediate (14-20%), or high (>20%)
    • Normal/Benign Result: Panel should show normal non-neoplastic breast tissue without malignant features
    • Abnormal Result: Any tumor cells showing marker expression patterns; defines cancer subtype and therapeutic targets
  • Interpretation
    • ER/PR Positive (Luminal Subtypes): Indicates hormone-responsive cancer; patients benefit from endocrine therapy including tamoxifen, aromatase inhibitors, or fulvestrant; generally associated with better prognosis
    • ER/PR Negative: Hormone therapy ineffective; may indicate HER2-positive or triple-negative breast cancer; chemotherapy typically recommended
    • HER2 Positive (3+ or FISH-amplified): Indicates HER2-enriched or HER2-positive luminal cancer; eligible for anti-HER2 targeted therapy (trastuzumab, pertuzumab, T-DM1); associated with more aggressive behavior but responsive to targeted treatment
    • HER2 Equivocal (2+): Requires reflex FISH or CISH testing for definitive determination of HER2 amplification status
    • HER2 Negative: Not eligible for anti-HER2 therapies; treatment based on hormone receptor status
    • Ki-67 Low (<14%): Indicates slowly proliferating tumor; associated with Luminal A subtype and lower risk of recurrence; generally better prognosis
    • Ki-67 High (>20%): Indicates rapidly proliferating tumor; associated with Luminal B and triple-negative subtypes; higher risk of recurrence and metastasis; may warrant more aggressive chemotherapy
    • Triple-Negative (ER-, PR-, HER2-): Most aggressive subtype; limited targeted therapy options; primary treatment is chemotherapy; may benefit from immunotherapy (pembrolizumab, atezolizumab) if PD-L1 positive; poorest prognosis of all subtypes
    • Factors Affecting Results: Prior therapy (chemotherapy may alter marker expression), tissue fixation quality, tumor heterogeneity, testing methodology variations
  • Associated Organs
    • Primary Organ: Breast tissue (mammary glands)
    • Conditions Diagnosed: Invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), special histologic types of breast cancer, and metastatic breast carcinoma
    • Affected Organ Systems: Lymphatic system (lymph node metastases), skeletal system (bone metastases), pulmonary system (lung metastases), hepatic system (liver metastases), central nervous system (brain metastases)
    • Potential Complications of Abnormal Results: Local recurrence, regional lymph node involvement, distant metastatic disease, treatment-related toxicities, chemotherapy-induced cardiotoxicity (especially with HER2-targeted agents), premature menopause from endocrine therapy
    • Associated Endocrine Issues: ER/PR-positive cancers may be influenced by estrogen/progesterone levels; tamoxifen carries risk of thromboembolic events and endometrial complications
  • Follow-up Tests
    • If HER2 is 2+ (Equivocal): FISH (Fluorescence In Situ Hybridization) or CISH (Chromogenic In Situ Hybridization) for HER2 gene amplification confirmation
    • Complementary Prognostic Tests: 21-gene recurrence score (Oncotype DX), 70-gene signature (MammaPrint), PAM50 assay for molecular subtyping, microarray analysis for genomic profiling
    • Staging and Metastatic Workup: Sentinel lymph node biopsy or axillary lymph node dissection, chest X-ray or CT chest/abdomen/pelvis, bone scan or PET-CT for stage III/IV disease
    • Tumor Marker Monitoring: Carcinoembryonic antigen (CEA), cancer antigen 15-3 (CA 15-3), human epididymis protein 4 (HE4) for ongoing surveillance
    • Immunotherapy Biomarkers (if Triple-Negative): PD-L1 expression testing, tumor-infiltrating lymphocytes (TIL) assessment
    • Cardiac Monitoring (if HER2-positive): Baseline and periodic echocardiogram or MUGA scan to assess left ventricular ejection fraction before HER2-targeted therapy
    • Genetic Testing: BRCA1/BRCA2 mutation analysis for hereditary breast cancer assessment, particularly in ER-negative or early-onset cases
    • Baseline Laboratory Tests: Complete blood count (CBC), comprehensive metabolic panel (CMP), liver function tests before initiating chemotherapy or targeted therapy
    • Ongoing Surveillance: Mammography and/or breast MRI every 6-12 months, clinical breast examination every 3-6 months for 5 years post-treatment, then annual surveillance
  • Fasting Required?
    • Fasting Requirement: No
    • Test Type: Histopathologic testing performed on tissue specimens (usually paraffin-embedded biopsy or surgical samples); no blood work required
    • Specimen Collection: Tissue sample obtained from biopsy, lumpectomy, or mastectomy performed under standard clinical protocols
    • Patient Preparation: No special preparation needed; follow standard pre-procedure instructions for biopsy or surgical sampling if tissue acquisition required
    • Medications: No medication restrictions; continue all regular medications unless specifically instructed otherwise by physician for tissue sampling procedure
    • Specimen Handling: Tissue must be properly fixed in formalin and processed promptly; avoid excessive delays between tissue collection and processing to preserve antigen detection
    • Turnaround Time: Typically 3-7 business days; may be expedited (24-48 hours) if clinically urgent

How our test process works!

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