Abstract
Objective: To generate national level statistics to calculate the disease burden and to implement awareness and screening programs for breast cancer.
Methodology: All breast biopsies received at the Dow Diagnostic Research and Reference laboratory (DDRRL) during 2008-2012 were included in the analyze the spectrum with implementation of latest intrinsic molecular sub-typing.
Results: Out of 2740 cases, 1493 (54.50%) were diagnosed as benign and 1247 (45.40%) as malignant lesions. Most frequent lesion in male was gynecomastia. However, in females, most common benign lesion was fibroadenoma with a frequency of 745 (27.91%), while invasive ductal carcinoma II was the most common malignant lesions observed in 584 (21.88%) cases. Mean age of patients with benign lesion was 30 years and malignant lesion was 45 years. Selected cases (n=460) were stained for ER, PgR and Her-2 expression. Of these, ER expression was found in 208 (44.30%) biopsies, PgR was found to be positive in 183 (38.90%) and Her-2 was positive in 44 (47.20%) biopsies. Intrinsic molecular sub-typing showed that 36% tumors were basal like, 28% were Lumial A, 18% were Luminal B Her-2 positive, 2% were Luminal B Her-2 negative and 16% were Her-2 positive.
Conclusion: Our study delineates interesting facts including increased magnitude of breast cancer prevalence in our setup (2008-2012). We represent four years data to demonstrate breast diseases specturm in the largest diagnostic and refernece laboratory of Sindh.

Key words: Breast diseases, breast cancer, DDRRL, Karachi