• VISHAL VERMA Department of Surgery, AFMS, New Delhi, India.
  • RAVISHEKAR N HIREMATH Department of Community Medicine, AFMS, New Delhi, India.
  • SHARANJIT SINGH BASRA Department of Surgery, AFMS, New Delhi, India.
  • PRANAV CHANDRAKANT KULKARNI Department of Surgery, AFMS, New Delhi, India.
  • SANDHYA GHODKE Department of Anaesthesiology, Rainbow Children’s Hospital, Bengaluru, Karnataka, India.




Surgical outcomes, Operable breast cancer, Molecular subtyping


Objectives: The aim of the study was to assess patients belonging to four main molecular subtypes (Luminal A, Luminal B, HER2 neu positive and Triple negative) and their treatment plans with a view to compare their early surgical complications and the final outcomes specific to the surgical procedure adopted and molecular subtype.

Methods: A Cross-sectional observational study at a Tertiary care center in central UP in a two-year period with Inclusion Criteria and Exclusion Criteria. Data Collection was carried out from the patients, diagnostic confirmation to rule out any exclusion criteria was performed. Clinical staging was done using the standard TNM criteria. All the specimens were subjected to immune-histochemical evaluation for surrogate molecular subtyping to see later the early surgical outcomes.

Results: Mean age ranged from 47.57±9.57 (Group III) to 50.67±8.08 (Group II) years and BMI ranged from 23.71 (Group IV) to 26.38 kg/m2 (Group II). Neoadjuvant chemotherapy use was reported in 15.6% of Luminal A group, 33.3% of Luminal B group, 40% of Her2 negative and 52.2% of Triple negative group cases. Statistically, there was a significant difference among groups with respect to use of neoadjuvant chemotherapy. Breast conservation therapy was the preferred surgical intervention in majority of cases with Luminal A (60%) and Luminal B subtype (66.7%) whereas MRM was preferred in 54.3% of Her2 negative and 65.2% of Triple negative cases. MRM was performed in 36% of Luminal A cases. Primary surgical intervention failure (BCS) was seen in 1 (4%) case with Luminal A subtype. In this patient, mastectomy was performed as the corrective measure. Surgical site infection was noted in 1 (4%) case in Luminal A group only. Seroma formation was noted in 4 (16%) of Luminal A, 8 (22.9%) of Her2 negative and 2 (8.7%) of Triple negative patients. No case of flap necrosis was noted. Follow-up duration ranged from 15 days to 36 months. Median duration of follow-up was 6 months. No mortality was noticed in any group.

Conclusion: Different surgical management strategies suggested that breast conservative surgery was more feasible in Luminal A cases whereas MRM was the preferred mode of surgery in other molecular subtypes. Within the limitations of short duration of follow-up, there was no significant difference among different molecular subtypes with respect to late complications and survival. Further studies with longer duration of follow-up and larger sample size are recommended.


Download data is not yet available.


Worldwide Cancer Data. American Institute for Cancer Research. Available from: https://www.wcrf.org/dietandcancer/worldwide-cancer-data

GLOBOCAN. New global cancer data. International Agency for Research on Cancer; 2020. Available from: https://www.uicc.org/news/ globocan-2020-new-global-cancer-datac

Surveillance. Epidemiology and End Results (SEER) Program. National Cancer Institute. Available from: https://seer.cancer.gov/3

Rakha EA, Reis-Filho JS, Baehner F, Dabbs DJ, Decker T, Eusebi V, et al. Breast cancer prognostic classification in the molecular era: The role of histological grade. Breast Cancer Res 2010;12:207. doi: 10.1186/ bcr2607, PMID 20804570

Reis-Filho JS, Pusztai L. Gene expression profiling in breast cancer: Classification, prognostication, and prediction. Lancet 2011;378:1812-23. doi: 10.1016/S0140-6736(11)61539-0, PMID 22098854

Weigelt B, Reis-Filho JS. Histological and molecular types of breast cancer: Is there a unifying taxonomy? Nat Rev Clin Oncol 2009;6:718-30. doi: 10.1038/nrclinonc.2009.166, PMID 19942925

Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ. WHO Classification of Tumours of the Breast. 4th ed. Lyon: IARC Press; 2012.

McCready D, Holloway C, Shelley W, Down N, Robinson P, Sinclair S, et al. Surgical management of early stage invasive breast cancer: A practice guideline. Can J Surg 2005;48:185-94. PMID 16013621

Lyman GH, Temin S, Edge SB, Newman LA, Turner RR, Weaver DL, et al. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2014;32:1365-83. doi: 10.1200/ JCO.2013.54.1177, PMID 24663048

Li J, Gonzalez-Angulo AM, Allen PK, Yu TK, Woodward WA,Ueno NT, et al. Triple-negative subtype predicts poor overall survival and high loco-regional relapse in inflammatory breast cancer. Oncologist 2011;16:1675-83. doi: 10.1634/theoncologist.2011-0196, PMID 22147002

Dominici LS, Mittendorf EA, Wang X, Liu J, Kuerer HM, Hunt KK, et al. Implications of constructed biologic subtype and its relationship to loco-regional recurrence following mastectomy. Breast Cancer Res 2012;14:R82. doi: 10.1186/bcr3197, PMID 22621306

Margalit DN, Sreedhara M, Chen YH, Catalano PJ, Nguyen PL, Golshan M, et al. Microinvasive breast cancer: ER, PR, and HER-2/ neu status and clinical outcomes after breast-conserving therapy or mastectomy. Ann Surg Oncol 2013;20:811-8. doi: 10.1245/s10434- 012-2640-8, PMID 22956068

Park S, Park BW, Kim TH, Jeon CW, Kang HS, Choi JE, et al. Lack of either estrogen or progesterone receptor expression is associated with poor survival outcome among luminal A breast cancer subtype. Ann Surg Oncol 2013;20:1505-13. doi: 10.1245/s10434-012-2772-x, PMID 23192228

Teija-Kaisa A, Eija M, Marja S, Outi L. Risk factors for surgical site infection in breast surgery. J Clin Nurs 2013;22:948-57. doi: 10.1111/ jocn.12009, PMID 23121264

Edwards JR, Peterson KD, Mu Y, Banerjee S, Allen-Bridson K, Morrell G, et al. National Healthcare Safety Network (NHSN) Report. Data summary for 2006 through 2008, issued December 2009. Am J Infect Control 2009;37:783-805. doi: 10.1016/j.ajic.2009.10.001, PMID 20004811



How to Cite

VERMA, V., R. N. HIREMATH, S. S. BASRA, P. C. KULKARNI, and S. GHODKE. “EARLY SURGICAL OUTCOMES OF OPERABLE BREAST CANCER PATIENTS BASED ON MOLECULAR SUBTYPING – A SINGLE-CENTRE STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 3, Mar. 2023, pp. 67-70, doi:10.22159/ajpcr.2023.v16i3.46564.



Original Article(s)

Most read articles by the same author(s)

1 2 > >>