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IHC Marker - Breast Prognostic Panel - 2 (ER, PR, HER2 / Ki67 Proliferative Index): Booking, Price, and Results

About IHC Marker - Breast Prognostic Panel - 2 (ER, PR, HER2 / Ki67 Proliferative Index): Booking, Price, and Results

Field	Value
Also Known As	Breast IHC Panel (ER, PR, HER2, Ki67); IHC Breast Hormone Receptor and Prognostic Panel; Immunohistochemistry Breast Panel
Sample Type	FFPE tissue block (formalin-fixed paraffin-embedded breast tissue from biopsy or surgical excision)
Fasting Required	No fasting required
Report Time	4 days (may extend to 7 to 10 working days for complex cases)
Recommended For	Male and female patients diagnosed with breast cancer
Price	Starting at ₹6,720

What is an IHC Marker – Breast Prognostic Panel – 2 (ER, PR, HER2 / Ki67 Proliferative Index)?

The IHC marker Breast Prognostic Panel-2 (ER, PR, HER2 / Ki67 proliferative index) is a specialised laboratory test performed on breast tumour tissue. It uses immunohistochemistry (IHC), a staining technique that applies lab-made antibodies to tissue samples to identify specific proteins in cancer cells. The test evaluates four key markers — oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 — to help oncologists understand the nature of the tumour and select the most suitable treatment approach. It is also known as the Breast Cancer Prognostic Panel-2 or the Immunohistochemistry Breast Panel.

What Does an IHC Marker - Breast Prognostic Panel -2 (ER, PR, HER2 / Ki67 Proliferative Index) Measure?

This panel analyses four specific protein markers in breast tumour tissue. Each marker provides a different piece of information about the cancer's behaviour and likely response to treatment.

Marker	What It Tells Us
Oestrogen Receptor (ER)	Whether the cancer cells have receptors that respond to oestrogen helps determine if hormone-blocking therapy may be effective
Progesterone Receptor (PR)	Whether cancer cells respond to progesterone; used alongside ER to assess suitability for hormone therapy
HER2 (Human Epidermal Growth Factor Receptor 2)	Whether the HER2 protein is overexpressed on cancer cells helps identify patients who may benefit from HER2-targeted therapy
Ki-67 Proliferative Index	How rapidly cancer cells are dividing; a higher percentage indicates a more aggressive tumour

Why is an IHC Marker – Breast Prognostic Panel – 2 (ER, PR, HER2 / Ki67 Proliferative Index) Done?

This test is not ordered based on symptoms. It is performed after a confirmed breast cancer diagnosis to characterise the tumour and guide treatment planning.

Common Symptoms That May Require This Test

This panel is typically recommended following a breast cancer diagnosis rather than in response to symptoms alone. The following findings on earlier investigations often lead a doctor to request this test:

A confirmed malignant mass on breast biopsy
Abnormal mammogram or ultrasound findings requiring further tissue characterisation
Inconclusive initial biopsy results needing detailed tumour profiling
Newly diagnosed breast cancer requiring subtype classification
Recurrence of breast cancer after previous treatment
Spread (metastasis) to other organs requiring re-evaluation of tumour markers

Conditions This Test Can Help Detect

Doctors use this test to gather information needed to classify and manage breast cancer. It supports the following purposes:

Classifying breast cancer into molecular subtypes such as Luminal A-like (ER+, PR+, HER2-, low Ki-67) and Luminal B-like (ER+/PR+, HER2+ or high Ki-67)
Identifying patients eligible for hormone therapies such as tamoxifen or aromatase inhibitors (for ER/PR-positive cancers)
Identifying patients eligible for HER2-targeted therapies such as trastuzumab (for HER2-positive cancers)
Assessing tumour aggressiveness through the Ki-67 proliferative index
Informing overall prognosis and treatment intensity

IHC Marker – Breast Prognostic Panel – 2 for Chronic Disease Monitoring

This test is usually performed at the time of diagnosis. However, it may be repeated if breast cancer returns or if the tumour's behaviour appears to have changed. In metastatic breast cancer, biomarker status can shift over time, so retesting may be recommended to ensure the treatment plan remains appropriate. This allows oncologists to track the disease and adjust therapy as needed.

How to Prepare and What to Expect

No special preparation is needed for this test, as the sample is tissue rather than blood. Here is what the process typically involves.

Do You Need to Fast?

No fasting is required for this test. The sample is a tissue block obtained through biopsy or surgical excision, so dietary restrictions do not apply.

Practical Tips Before Your Test

A few steps will help ensure the process runs smoothly. Keep the following points in mind:

Bring a detailed clinical history, including your symptoms, previous test results, previous cancer treatments, and family history, as this is required for the test
Ensure the tissue sample is properly preserved in formalin immediately after collection, as stated by your treating doctor or surgical team
Carry any previous pathology reports, imaging results, or biopsy reports to your appointment
Discuss with your doctor whether poly-L-lysine coated slides or a paraffin block is needed, and confirm the sample submission format with the laboratory in advance
Ask your surgeon or oncologist about the correct packaging and transport instructions for your tissue sample

Step-by-Step Procedure

The following steps describe how the sample is collected and processed for this test.

Your doctor arranges a breast biopsy or surgical excision to obtain a tissue sample from the tumour, which may involve fine needle aspiration, core needle biopsy, or surgery.
The tissue is fixed in formalin for preservation and then embedded in paraffin wax to form an FFPE block.
The FFPE block or slides are sent to the laboratory at room temperature, accompanied by a request form and your clinical history.
In the lab, thin tissue slices are mounted on slides and treated with specific antibodies for ER, PR, HER2, and Ki-67.
A chemical reaction causes the antibodies to change colour upon binding to target proteins, indicating the presence and extent of markers.
A trained pathologist examines the stained slides under a microscope, scores each marker per guidelines, and prepares the final report.

Factors That Can Affect Accuracy

Several factors can influence the reliability of IHC results. Being aware of them helps set realistic expectations:

Quality of tissue fixation; inadequate formalin fixation is a leading cause of inaccurate results
Delays in processing or improper sample transport
Variations in staining protocols between different laboratories
The experience and expertise of the pathologist reading the slides
Pre-analytical variables such as prolonged cold ischaemia time (time between tissue removal and fixation)
Inter-observer variability when different pathologists interpret the same slide

Understanding Your IHC Marker - Breast Prognostic Panel -2 (ER, PR, HER2 / Ki67 Proliferative Index) Results

Results from this panel are expressed as scores or percentages for each marker. The table below outlines the general interpretation framework used by pathologists.

Marker	Result	Interpretation
ER	1% or more positive tumour nuclei	Positive (Allred score 0 to 8)
ER	Less than 1% positive nuclei	Negative
PR	1% or more positive tumour nuclei	Positive (Allred score 0 to 8)
PR	Less than 1% positive nuclei	Negative
HER2	Score 0 to 1+	HER2-negative
HER2	Score 2+	Borderline or equivocal; FISH test recommended
HER2	Score 3+	HER2-positive
Ki-67	5% or less	Low proliferation (slow-growing tumour)
Ki-67	6% to 29%	Intermediate proliferation
Ki-67	Greater than 30%	High proliferation (fast-growing, more aggressive tumour)

These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.

How to Maintain Healthy Levels

While IHC results reflect the biology of a diagnosed tumour rather than a modifiable health metric, the following general wellness steps are relevant:

Maintain a healthy body weight through balanced nutrition and regular physical activity, as these factors may influence tumour biology and overall cancer outcomes
Attend regular breast screening (mammograms and clinical examinations) as recommended by your doctor, particularly if you have a family history of breast cancer
Discuss all results with your oncologist to understand your specific tumour profile and to explore the most suitable treatment pathway for your situation

Lupin Diagnostics IHC Marker - Breast Prognostic Panel -2 (ER, PR, HER2 / Ki67 Proliferative Index) Price

The IHC marker – breast prognostic panel-2 test at Lupin Diagnostics is priced starting at ₹6,720. This test requires a visit to a Lupin Diagnostics centre or a partnered hospital facility, as home collection is not available for tissue-based IHC tests.

City	Approximate Price (₹)
BHOPAL	6720
CHENNAI	6720
HYDERABAD	6720
KOLKATA	6720
NAVI MUMBAI	6720
PUNE	6720

Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.

How to Book

Booking your IHC marker – breast prognostic panel-2 test online is straightforward. Follow these steps:

Select the test on the Lupin Diagnostics website.
Choose your city and preferred centre location.
Visit the centre at your scheduled time for sample submission.
Receive your report via email or WhatsApp within the stipulated turnaround time.

Frequently Asked Questions

This test is performed on breast tumour tissue and evaluates four markers — ER, PR, HER2, and Ki-67 — using an immunohistochemistry staining technique. The results help oncologists classify the cancer into a molecular subtype and decide which therapies are most likely to be effective. It is part of standard breast cancer workup following a confirmed diagnosis.

A breast cancer diagnosis on its own does not reveal how the tumour will behave or which treatments will work. These four markers tell doctors whether the cancer is driven by hormones (ER/PR), whether it overexpresses HER2, and how aggressively it is growing (Ki-67). This information shapes the entire treatment plan.

The sample is obtained through a breast biopsy, which your surgeon or oncologist will arrange. This may be a fine needle aspiration, a core needle biopsy, or a surgical excision. The tissue is then fixed in formalin and sent to the laboratory as an FFPE block. No separate procedure is needed purely for this test.

A HER2 score of 2+ is considered borderline. In such cases, a follow-up FISH (fluorescence in situ hybridisation) test is usually recommended on the same tissue sample. The FISH test provides a more definitive answer about whether the cancer is truly HER2-positive or HER2-negative.

A Ki-67 index above 30% indicates that a large proportion of cancer cells are actively dividing, which is associated with a more aggressive tumour. Conversely, a Ki-67 of 5% or less suggests slow-growing cancer. Your oncologist will consider this alongside the other three markers when planning your treatment.

Yes, particularly in metastatic breast cancer. Tumour marker status, including ER, PR, and HER2, can change over the course of the disease. If cancer recurs or spreads, retesting the new tissue sample may be recommended to ensure the treatment approach remains appropriate.

Results are typically available within 4 days at Lupin Diagnostics. Complex cases, or those requiring an additional FISH test for equivocal HER2 results, may take longer. Your doctor or the laboratory will inform you of the expected turnaround at the time of sample submission.