Browsing by Author "Peiris, H.H."

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Nottingham grade 2 breast cancer; is it a true prognostic category?
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Peiris, H.H.; Mudduwa, L.K.B.; Thalagala, N.I.; Jayatilake, K.A.P.W.
BACKGROUND: Nottingham grade (NG) is a well-recognized prognostic factor derived by adding scores (1-3) given for three histological features of breast cancer (BC). NG is assigned according to the final score (NG1=score 3-5, NG2=score 6-7, NG3=score 8-9) where NG1 has the best and NG3 has the worst prognosis. OBJECTIVE: To assess whether the NG2 entails only patients with a similar prognosis. METHODS: Data were collected from all NG2 BC patients who had sought the services of our unit from 2006 to 2012. Grading was done by a single investigator. Patients were divided into two groups according to the score assigned in grading (6 and 7) and followed up with a mean follow-up time of 45 (SD=23) months. Clinico-pathological features were compared using chi-square test. Kaplan-Meier model with log-rank test was used for survival analysis. RESULTS: The study included 352 NG2 BC patients (score 6=195; score 7=157) with a mean age of 52 (SD=11) years. Majority of the patients with score 6 had ER/PR positive tumours (p=0.007 and 0.029) whereas score 7 patients had Her 2 positive tumours (p=0.002). There was a significant survival difference between the patients who had scores 6 and 7 (breast cancer specific survival p=0.007; recurrence free survival p=0.019). There was no survival difference between the patients with NG1 and score 6 and NG3 and score 7 (p>0.05). CONCLUSIONS: NG2 comprises two subsets of patients with a significant survival difference. Their prognosis is more in line with the preceding/subsequent grade than the same grade, probably due to the difference in ER/PR and Her 2 expression.
Role of Cancer antigen 15.3 in the pre-operative assessment of primary breast cancer
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Peiris, H.H.; Mudduwa, L.K.B.; Wijeratne, W.M.D.G.B.; Liyanage, T.G.; Liyanage, N.C.; Gunasekara, S.N.; Kaushalya, M.H.A.
BACKGROUND: Cancer antigen (CA) 15.3 is the most commonly used tumour marker in predicting recurrence of breast cancer. The role of pre-operative CA 15.3 in the assessment of breast cancer has not been substantiated yet. OBJECTIVE: To determine the role of CA 15.3 in the pre-operative assessment of breast cancer patients METHODS: All patients who were diagnosed of primary breast cancer and underwent surgery at a tertiary-care hospital from April 2014 to October 2015 were enrolled. Serum level of CA 15.3 was assessed on a pre-operative blood sample by ELISA and ≥30 U/ml was considered as the cut off as defined by the manufacturer’s literature. The association of CA 15.3 levels with the clinico-pathological parameters was analyzed with chi-square test. RESULTS: Of the 150 patients (mean age 56.83 [SD=13.39] years) enrolled, majority (85.6%) had grade 2/3 tumours with lymph node metastasis (58.2%) at the time of presentation. None had distant metastasis. Elevated pre-operative serum level of CA 15.3 was detected in 34% of patients who had more estrogen receptor negative(43.13%), progesterone receptor negative (50.98%) and triple negative(29.1%) tumours compared to those without elevated pre-operative CA 15.3 (p=0.017,0.036 and 0.001 respectively). There was no association with other clinico-pathological features. CONCLUSIONS: Pre-operative serum level of CA15.3 is elevated only in one third of breast cancer patients. Elevated pre-operative CA 15.3 has a prognostic value as it is elevated mostly in the hormone receptor negative and triple negative breast cancers predicting a poor prognosis.