Association of ER, PR, and HER2 Biomarker Profiles with Histological Grade of Breast Carcinoma in Pre- and Postmenopausal Patients
Submission: 20 July 2025 | Acceptance: 25 September 2025 | Publication: 11 November 2025
1Dr. Zamin Abbas, 1Dr. Usman Khan, 1Dr. Hub-e-Ali, 2Dr. Haroon Raja, 1Dr. Asia Naz, 1Dr. Tabassum Raja, 3Kashif Lodhi
1Assistant professor, Department of Radiotherapy & Nuclear Medicine Dr Faisal Masood Teaching Hospital Sargodha.
2PIMS, Islamabad
3Department of Agricultural, Food and Environmental Sciences. Università Politécnica delle Marche Via Brecce Bianche 10, 60131 Ancona (AN) Italy
Abstract:
Background: Breast malignancy exhibits distinct molecular and histopathological characteristics depending on menopausal status. Hormone receptors (ER, PR) and HER2 expression play an important role in prognosis and treatment. This study investigates the association of ER, PR, HER2 expression, and histological tumor grading among premenopausal and postmenopausal women with invasive ductal carcinoma. Objective: To evaluate and compare the expressions trends of ER, PR, HER2, and histological grades of breast carcinoma between premenopausal and postmenopausal women. Methodology: This observational, analytical cross-sectional research was carried out at Jinnah Postgraduate Medical Center, Karachi, from December 2023 to December 2024. A total of 200 histologically confirmed breast carcinoma patients aged 25–75 years were enrolled through nonprobability consecutive sampling. ER, PR, and HER2 values were assessed by immunohistochemistry, and histological grading was done using the modified Bloom-Richardson system. Patients were stratified by menopausal status. Data were analyzed using SPSS version 26; associations were tested using chi-square with a significance level of p < 0.05. Results: ER and PR positivity were significantly higher in postmenopausal women (73.2% and 66.1%) compared to premenopausal women (47.7% and 43.2%) (p < 0.001, p = 0.001). HER2 overexpression (3+) was more frequent in premenopausal women (34.1% vs. 19.6%, p = 0.007). Grade III tumors predominated in postmenopausal women (48.2%, p =
0.002). HER2 positivity correlated significantly with higher tumor grades, particularly in premenopausal patients (p = 0.004). Conclusion: Premenopausal women demonstrated a higher prevalence of aggressive HER2-positive subtypes and poorly differentiated tumors, whereas postmenopausal women showed higher ER/PR positivity, suggesting divergent tumor biology and therapeutic implications based on menopausal status. Keywords: Breast cancer, Estrogen receptor, HER2, Histological grade, Menopausal status.