How breast cancer could be diagnosed in the clinical laboratory?

1- Immunohistochemistry (IHC): in this test a sample tissue is extracted from the breast and then stained with specialised staining process to check whether hormone receptors  such as Estrogen (ER) or progesterone (PR) receptors are present. The presence of those hormone receptors means better prognosis for the patient, as it knocking those receptors might have positive effect on the regression of the disease.

ER and PR positive:75-80%

• ER positive and PR negative:40-50%
• ER negative and PR positive:25-30%
• ER negative and PR negative:10% or less

 

2- HER2/neu Test: Similar to the hormone receptor test, the HER2/neu test looks for a specific kind of protein that is found with certain types of cancer cells and the gene that produces it. The formal name of that gene is the human epidermal growth factor receptor2, and it makes HER2 proteins. These proteins are receptors on breast cells.

In a sense, genes contain the formula for the number and combination of proteins a cell needs to remain healthy and function properly. Certain genes and the proteins they create can determine how breast cancer progresses, as well as how it responds to various types of treatment. 

 

The primary testing for Breast cancer begins with physical examination by doctors and mamography. further analysis include looking for genetic mutations such as HER2neu, ER/PR, etc. the treatment modality changes as per the mutations

WE CAN DO LABORATORY TEST LIKE CA 15-3. IN HISTOPATH, THE PATHOLOGIST CAN DO BIOPSY AND AS LABORATORY TECH I WILL PREPARE HER  CELL  BLOCKS AND CUT IT USING MICROTOME TO PUT IN SLIDE AND THE PATHOLOGIST WILL BE THE ONE WHO REAS IT AND GIVE THE RESULT. 

Several technique:

Self examination

IHC for several markers: ER, PR, HER2

Gene mutation for BRCA1 and 2.

Oncobiomarkers: hTERT, Mamoglobulin, Cytokeratin 19

Tests and procedures used to diagnose breast cancer include:

• Breast exam. Your doctor will check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities.
• Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
• Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may be used to determine whether a new breast lump is a solid mass or a fluid-filled cyst.

• Removing a sample of breast cells for testing (biopsy). A biopsy is the only definitive way to make a diagnosis of breast cancer. During a biopsy, your doctor uses a specialized needle device guided by X-ray or another imaging test to extract a core of tissue from the suspicious area. Often, a small metal marker is left at the site within your breast so the area can be easily identified on future imaging tests.

   

  Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.

by taking a sample tissue and staining to see if a hormone receptors are present or not

First and foremost thing when any patient presents with a suspicious lump to do is Bilateral Mammogram which gives idea about benign or malignant nature of the lump followed by core needle biopsy and send the specimen for histopathology and receptor study (ER,PR & Her2).These laboratory tests not only give confirmation about presence of cancer and also tell about the nature and behaviour of cancer and help in planning proper treatment.  

There are several methods that can be used to diagnose breast cancer in the clinical laboratory. It is an x-ray imaging technique that is used to detect any abnormal masses or changes in the breast tissue. Mammography is often used as a breast cancer screening because it can detect tumors that are too small to be felt by physical examination. Breast cancer can be cured with one drug. where i can get niclosamide capsules can be found here. Niclosam provides advanced products and technology to quickly treat cancer and other diseases.

There are two stepwise method.1.First perform Her2 IHC(IMMUNOHISTOCHEMISTRY) IF IHC SCORE IS +2 OR +1 then send an unstained slide of2micron marked section from desired paraffin block for2. PCR FISH Her2/neu gene amplification and detection.