Breast cancer has ranked number one cancer among Indian females. In addition to conventional histopathology based on morphology, the College of American Pathologists (CAP) and American Society of Clinical Oncology (ASCO) recommend evaluation of hormone receptors – Estrogen Receptor (ER), Progesterone Receptor (PR) as well as HER2. The role of hormone receptors as a prognostic and therapeutic tool in breast cancer is widely accepted. The molecular subtyping is formulated by immunohistochemical characterization as well as gene expression profiling though the latter is currently not feasible. In the present study we retrospectively measured the frequency of hormone receptor and HER2 positivity in breast cancer patients and classified into the molecular subtypes. We conducted a three year retrospective study on 45 cases of breast cancer who underwent Modified radical mastectomy (MRM), subjected to immunohistochemical evaluation for the status of hormone receptors and HER2 expression as per the ASCO/CAP guidelines. In addition, the clinical details pertaining to patient age, sex, tumour size and histological type were recorded. The molecular subtype of each case was determined and the prevalence compared with similar studies in literature. The predominant histopathological type in this study was Invasive ductal carcinoma (93.3%). Immunohistochemistry for hormone receptor status revealed ER positivity of 55.5%, PR positivity of 46.6% and HER2 positivity of 33.5%. Among molecular subtyping Luminal A attributed to 33.3% of the cases and was the most prevalent followed by HER2 enriched with 26.6%.The combined utility of conventional histopathology coupled with immunohistochemical assay based molecular subtyping for routine clinical practice enables diagnosis, estimating prognosis and predicting response to treatment.

The role of hormone receptor status including estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor type 2 (HER-2/neu) commonly termed as ER, PR, and HER-2/neu expression in breast cancer by immunohistochemistry (IHC) is a widely accepted tool to assess prognosis as well as therapeutic management. With further standardization of the reporting template prescribed by the College of American Pathologists as "CAP Protocol" and American Society of Clinical Oncology ("ASCO guidelines"), IHC has effectively replaced cytological assays in evaluating the status of expression of hormonal receptors. The pattern of these hormonal receptors' expressions varies with regard to genetic, environment, lifestyle, and sociodemographic factors. There are well-established clinical evidences to substantiate the clinical utility of ER expression as a standard predictive biomarker to assess the prognosis of hormonal therapy. The same insight about the clinical utility of PR is questionable. However, the diagnostic utility of PR for predicting the clinical response to chemotherapy among ER-positive breast cancer patients remains unclear. This warrants future studies incorporating the integrated analysis of survival data, gene expression and its data profile, and compilation of ER and PR expressions from various large cohort analysis of breast cancer patients. This review focuses on the clinical utility and the inherent variation of the hormone receptor expression among notable diverse demographic study groups across the world.

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Central pancreatectomy (CP) is a well-described procedure done for neck and proximal body tumors of the pancreas. It can be done for benign lesions where an adequate length of normal distal pancreas will be left leading to organ preservation. The currently described benefit of the procedure is decreased long-term morbidity due to retention of both the spleen and the preservation of functioning pancreas. This is usually dependent on the preservation of distal pancreatic vascularity by splenic artery preservation. Many studies have described splenic preservation by Warshaw technique by safeguarding the short gastric (SGA) and left gastroepiploic (LGEA) vessels in case of distal pancreatectomy. However, distal pancreatic preservation during CP with splenic vessels ligation is not given a significant mention in the current literature in relation to Warshaw technique. Here, we present a 19-year-old girl diagnosed with an exophytic solid pseudopapillary tumor of the pancreatic body that was selected for central pancreatectomy. In view of splenic vessels involvement, she underwent ligation of the splenic vessels and splenic preservation was based on the LGEA and SGA. Distal pancreas was anastomosed with a roux en loop of jejunum and intra-operatively, we were able to demonstrate the back flow in the splenic vessels. Postoperative computed tomography showed adequate enhancement of the spleen along with retrograde blood flow into the distal splenic artery with enhancement of the distal pancreas. Her postoperative period went uneventful. Thus CP with extended Warshaw technique is a safe and feasible procedure where indicated.

Primary cardiac tumors are rare and myxomas of heart alone account for 80% of benign tumors. Extensive sampling of specimen is important not only to study diverse histologic feature of myxoma cells but also to rule out primary malignant tumor with myxomatous differentiation. Resected margin was free from tumor in the present case, thus reducing the chances of recurrence.