Distinguishing medullary carcinoma of the breast from high-grade hormone receptor-negative invasive ductal carcinoma: an immunohistochemical approach

Histopathology
Uta FluckeHeidrun Gevensleben

Abstract

Medullary carcinomas (MCs) represent a rare breast cancer subtype associated with a rather favourable prognosis compared with invasive ductal carcinomas (IDCs). Due to histopathological overlap, MCs are frequently misclassified as high-grade IDCs, potentially leading to overtreatment of MCs. Our aim was to establish novel diagnostic markers distinguishing MCs from hormone receptor-negative high-grade IDCs. Sixty-one MCs and 133 hormone receptor-negative IDCs were analysed in a comparative immunohistochemical study. Applied markers included a comprehensive panel of cytokeratins (CKs), vimentin, smooth muscle actin (SMA), p63, p53, cell adhesion molecules [N-CAM (CD56), syndecan-1 (CD138), E-cadherin and P-cadherin] and development associated transcription factors (AP-2 alpha, AP-2 gamma). A significantly higher proportion of IDCs displayed increased expression of CK7, AP-2 alpha and HER2 in contrast to MCs (CK7: 91% of IDCs versus 77% of MCs; AP-2 alpha: 77% versus 57%; and HER2: 26% versus 7%, each P < 0.01). Vice versa, MCs were slightly more frequently positive for SMA and vimentin (P > 0.05). Hormone receptor-negative high-grade IDCs are significantly associated with luminal differentiation, Her2 and AP-2 alpha overexpressio...Continue Reading

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Citations

Sep 18, 2010·Der Pathologe·H GevenslebenR Büttner
Jun 19, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J HuoberB Thürlimann
Dec 30, 2014·Frontiers in Immunology·Jose Villacorta HidalgoPaul Fisch
Jan 24, 2014·Journal of breast cancer·Inhye ParkSeok Jin Nam
Sep 28, 2016·The Breast Journal·Fadila KouhenNoureddine Benjaafar
Apr 20, 2017·The Breast Journal·Andrzej StelmachBeata Sas-Korczyńska
Nov 1, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J HuoberB Thürlimann

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