Document Detail

The role of immunohistochemistry for smooth-muscle actin, p63, CD10 and cytokeratin 14 in the differential diagnosis of papillary lesions of the breast.
MedLine Citation:
PMID:  16698948     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Histological differentiation of mammary papillary lesions can be difficult. The evaluation of myoepithelial cells can be helpful, with benign papilloma showing a continuous myoepithelial cell layer, which becomes attenuated or absent in malignant papillary lesions. METHODS: A large series of 100 papillomas (28 papillomas with florid epithelial hyperplasia) and 68 papillary carcinomas (9 invasive, 44 in situ, and 15 ductal carcinomas in situ (DCIS) involving papillomas) of the breast were stained for myoepithelial cells by immunohistochemistry using antibodies to smooth-muscle actin (SMA), p63, CD10 and cytokeratin (CK) 14. RESULTS: In the papillomas, using these four antibodies, myoepithelial cells were positive in 88%, 99%, 91% and 95% of cases, respectively, with SMA showing marked stromal component cell staining and CD10 showing epithelial and stromal staining. CK14 also showed epithelial staining in 71% of papillomas and 96% of papillomas with florid epithelial hyperplasia. In the papillary carcinomas, 36 (53%) cases showed staining of myoepithelial cells that were scattered, discontinuous and diminished in number and the remaining 32 (47%) cases did not show myoepithelial cells. Invasive papillary carcinoma has the lowest proportion (33%) with myoepithelial cells, and DCIS involving papillomas had the highest proportion (87%). CONCLUSIONS: p63 had the highest sensitivity and did not cross-react with stromal cells and only rarely with epithelial cells. CK14 has the added ability to distinguish between florid epithelial hyperplasia involving papilloma and DCIS involving papillomas. CK14 and p63 may be used as an adjunct in assessing difficult papillary lesions of the breast.
G M K Tse; P-H Tan; P C W Lui; C B Gilks; C S P Poon; T K F Ma; B K B Law; W W M Lam
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Publication Detail:
Type:  Journal Article     Date:  2006-05-12
Journal Detail:
Title:  Journal of clinical pathology     Volume:  60     ISSN:  0021-9746     ISO Abbreviation:  J. Clin. Pathol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-05-01     Revised Date:  2010-09-14    
Medline Journal Info:
Nlm Unique ID:  0376601     Medline TA:  J Clin Pathol     Country:  England    
Other Details:
Languages:  eng     Pagination:  315-20     Citation Subset:  AIM; IM    
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China.
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MeSH Terms
Actins / metabolism
Aged, 80 and over
Breast Neoplasms / metabolism*,  pathology
Carcinoma, Intraductal, Noninfiltrating / metabolism,  pathology
Carcinoma, Papillary / metabolism,  pathology
DNA-Binding Proteins / metabolism
Diagnosis, Differential
Keratin-14 / metabolism
Middle Aged
Neoplasm Proteins / metabolism
Neprilysin / metabolism
Papilloma / metabolism,  pathology
Papilloma, Intraductal / metabolism,  pathology
Trans-Activators / metabolism
Tumor Markers, Biological / metabolism*
Tumor Suppressor Proteins / metabolism
Reg. No./Substance:
0/Actins; 0/DNA-Binding Proteins; 0/Keratin-14; 0/Neoplasm Proteins; 0/TP63 protein, human; 0/Trans-Activators; 0/Tumor Markers, Biological; 0/Tumor Suppressor Proteins; EC

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