The role of immunohistochemistry in the differential diagnosis of papillary lesions of the breast

G M Tse
May 2009
Journal of Clinical Pathology;May2009, Vol. 62 Issue 5, p407
Academic Journal
Papillary lesions of the breast represent a heterogeneous group with differing biological behaviour. Correct diagnosis is crucial but may be difficult, as many benign and malignant papillary lesions have similar appearances. Immunohistochemistry plays a useful role in their differentiation. Myoepithelial markers can help in differentiating papilloma from papillary carcinoma, as the former usually shows a continuous layer of myoepithelial cells. In intracystic papillary carcinoma, there is controversy as to the presence of a complete myoepithelial cell layer around these lesions. p63 is the marker of choice as the staining is nuclear, cross-reactivity is minimal, and sensitivity is high. Papilloma may frequently be complicated by superimposed different types of epithelial hyperplasia, which range from usual to atypical or even ductal carcinoma in situ, and they many be morphologically similar. Basal cytokeratins (CKs) are useful to differentiate these entities; as usual hyperplasia is positive for basal CKs with a mosaic staining pattern. CK5/6 is probably the best marker. Neuroendocrine markers (chromogranin A and synaptophysin) may be positive in papillary carcinoma, particularly in the solid type, and there may be some overlap with the ductal carcinoma in situ with spindle cells or endocrine ductal carcinoma in situ. A panel of CK5/6, p63 and neuroendocrine markers can be useful in the diagnostic investigation of problematic papillary lesions of the breast. As the experience with these markers remains rather limited, it is too early to recommend basing treatment choices on these marker studies alone. Complete removal of lesion is probably still the treatment of choice.


Related Articles

  • Carcinoma de mama con células gigantes tipo osteoclasto. Informe de un caso de una variante rara. Murguía-Pérez, Mario; Durán-Padilla, Marco Antonio; Cruz-Gordillo, Ana Guadalupe; Trejo-Pantoja, José Antonio; Mendoza-Ramírez, Saulo // Revista Española de Patología;oct-dic2012, Vol. 45 Issue 4, p230 

    Breast carcinoma with osteoclast-like giant cells (BCOGC) is a rare, distinctive form of breast cancer. Although cases have been reported with many growth patterns in almost all types of breast cancer, being rarely found in well differentiated tumours. We report a case of well-differentiated...

  • MCF-7 Human Breast Cancer Cells Form Differentiated Microtissues in Scaffold-Free Hydrogels. Vantangoli, Marguerite M.; Madnick, Samantha J.; Huse, Susan M.; Weston, Paula; Boekelheide, Kim // PLoS ONE;8/12/2015, Vol. 10 Issue 8, p1 

    Three-dimensional (3D) cultures are increasing in use because of their ability to represent in vivo human physiology when compared to monolayer two-dimensional (2D) cultures. When grown in 3D using scaffold-free agarose hydrogels, MCF-7 human breast cancer cells self-organize to form...

  • Taurine: a novel tumor marker for enhanced detection of breast cancer among female patients. El Agouza, I.; Eissa, S.; El Houseini, M.; El-Nashar, Dalia; Abd El Hameed, O. // Angiogenesis;Sep2011, Vol. 14 Issue 3, p321 

    Introduction: The antioxidant Taurine found to display antineoplastic effect through down regulation of angiogenesis and enhancement of tumor cell apoptosis. It has been found that progressive inhibition of apoptosis and induction of angiogenesis may contribute to tumor initiation, growth and...

  • Bilobalide Induces Neuronal Differentiation of P19 Embryonic Carcinoma Cells via Activating Wnt/β-Catenin Pathway. Liu, Mei; Guo, Jingjing; Wang, Juan; Zhang, Luyong; Pang, Tao; Liao, Hong // Cellular & Molecular Neurobiology;Aug2014, Vol. 34 Issue 6, p913 

    Bilobalide, a natural product extracted from Ginkgo biloba leaf, is known to exhibit a number of pharmacological activities. So far, whether it could affect embryonic stem cell differentiation is still unknown. The main aim of this study was to investigate the effect of bilobalide on P19...

  • Effect of 3D-scaffold formation on differentiation and survival in human neural progenitor cells. Ortinau, Stefanie; Schmich, Jürgen; Block, Stephan; Liedmann1, Andrea; Jonas, Ludwig; Weiss, Dieter G.; Helm, Christiane A.; Rolfs, Arndt; Frech, Moritz J. // BioMedical Engineering OnLine;2010, Vol. 9, p70 

    Background: 3D-scaffolds have been shown to direct cell growth and differentiation in many different cell types, with the formation and functionalisation of the 3D-microenvironment being important in determining the fate of the embedded cells. Here we used a hydrogel-based scaffold to...

  • Detection and diagnosis.  // Annals of Oncology;Mar2011 Supplement 2, Vol. 22 Issue suppl_2, pii37 

    No abstract available.

  • Pathology of Breast Carcinomas After Neoadjuvant Chemotherapy. Sahoo, Sunati; Lester, Susan C. // Archives of Pathology & Laboratory Medicine;Apr2009, Vol. 133 Issue 4, p633 

    Context.-Currently, more women are being treated with chemotherapy or hormonal agents before surgery (neoadjuvant chemoendocrine therapy) for earlier-stage operable breast carcinoma. The pathologic examination of these specimens can be quite challenging. Objective.-To give an overview of (1)...

  • A Novel PET Imaging Using 64 Cu-Labeled Monoclonal Antibody against Mesothelin Commonly Expressed on Cancer Cells. Kobayashi, Kazuko; Sasaki, Takanori; Takenaka, Fumiaki; Yakushiji, Hiromasa; Fujii, Yoshihiro; Kishi, Yoshiro; Kita, Shoichi; Shen, Lianhua; Kumon, Hiromi; Matsuura, Eiji // Journal of Immunology Research;3/25/2015, Vol. 2015, p1 

    Mesothelin (MSLN) is a 40-kDa cell differentiation-associated glycoprotein appearing with carcinogenesis and is highly expressed in many human cancers, including the majority of pancreatic adenocarcinomas, ovarian cancers, and mesotheliomas, while its expression in normal tissue is limited to...

  • Intraductal Proliferative Lesions of the Breast-Terminology and Biology Matter: Premalignant Lesions or Preinvasive Cancer? Costarelli, Leopoldo; Campagna, Domenico; Mauri, Maria; Fortunato, Lucio // International Journal of Surgical Oncology;2012, p1 

    Morphological criteria for the diagnosis of intraductal proliferative lesions of the breast have been an object of research and much controversy, and its terminology is rather confusing. Knowledge of the molecular aspects of this disease probably necessitates further research to clarify if these...


Read the Article


Sign out of this library

Other Topics