Prognostic factors of Ca. breast include all except:

Ans: d (E cadherin) Ref: Robbins, 7th ed, p. 1147E cadherin is a glycoprotein that acts as glue between epithelial cells. Loss of cadherin favours malignancy by allowing easy disintegration of cells leading to local invasion / metastasis. Even though reduced cell surface expression of E cadherin is associated with many types of carcinomas including Ca breast, it's not mentioned as a prognostic factor (major / minor) for the same.Prognostic factors - Ca. breast:Major:1. Invasive / insitu - invasive poor prognosis2. Distant metastasis - poor prognosis3. Lymph node mets - Axillary LN status is the single most important prognostic factor in the absence of mets4. Tumour size - 2nd most important prognostic factor in the absence of mets5. Locally advanced disease - invading skin / skeletal muscles - poor prognosis6. Inflammatory carcinoma - poor prognosisMinor:1. Histological subtype - 'No special type' is poorer than 'special types' like tubular, mucinous, medullary etc.2. Tumour grade - (Scarff Blood Richardson system) Higher the grade, poorer the prognosis3. Hormone receptors -Estrogen receptor(+), Progesterone receptor (+) = 80% respond to therapy.Either E or P = 40% respond to therapyEstrogen (-), progesterone (-) = < 10% respond to therapy4. Her 2neu / Human epidermal growth factor receptor / C erb B2Over expression is associated with poor prognosis