Combined evaluation of CK5/6, ER, p63, and MUC3 for distinguishing breast intraductal papilloma from ductal carcinoma in situ

Abstract

The differentiation of intraductal papilloma (IDP) in the breast from ductal carcinoma in situ (DCIS) is sometimes difficult. Fifty papillary lesions (25 DCIS and 25 IDP) were immunohistochemically examined using a panel of antibodies, including CK5/6, ER, p63, Ki‐67, chromogranin A, synaptophysin, neuron specific enolase, CD56, MUC1, MUC3, CD44, p21, p27, and p53. The immunohistochemical staining pattern of each antibody was evaluated using the Allred scoring system. Then, the area under curve (AUC) for each antibody was computed by receiver operating characteristic (ROC) analysis. DCIS typically showed high scores for ER and MUC3 reactivity compared with IDP, and the AUC for ER and MUC3 were 0.941 and 0.908, respectively. In contrast, IDP showed high scores for CK5/6 and p63 reactivity compared with DCIS, and the AUC for CK5/6 and p63 were 1.00 and 0.954, respectively. We devised a ‘Differential Index’ (DI) using the following formula: [S(ER) + S(MUC3)]/[S(CK5/6) + S(p63) + 1]. The distributions of the DI for IDP and DCIS did not overlap when the cutoff value was placed arbitrarily at DI = 1.0. From these results, it is concluded that a panel of four CK5/6, ER, p63, and MUC3 antibodies provide valuable information for differentiating IDP from DCIS.

Effectiveness of computer-aided diagnosis (CADx) of breast pathology using immunohistochemistry results of core needle biopsy samples for synaptophysin, oestrogen receptor and CK14/p63 for classification of epithelial proliferative lesions of the breast

“…Markers in breast tissue that have been analysed include HMWCK,4 14 21–23 myoepithelial markers,4 21 22 mucin 3 (MUC3),22 ER,22 cyclin D1,23 chromogranin A4 and synaptophysin 4 13…”

Clinical Value of Nipple Discharge and Serum Markers of Breast Cancer

“…It locates in or originates from mammary ducts and generally harbors a benign or malignant breast tumor [2][3][4][5]. Abnormal nipple discharge is most commonly caused by benign conditions like intraductal papillomas, duct ectasia, papillomatosis, mastitis, fibrocystic changes [6][7][8][9]. The incidence of breast cancer in patients presenting with abnormal nipple discharge is between 5% to 21% [2,3,10].…”

“…Of the patients presented with nipple discharge, the incidence of malignancy is reported as a range from 5% to 21% [5][6]. A large portion of patients with nonpuerperal nipple discharge contain one or several symptoms including: spontaneous unilateral, serous and bloody discharge [7]. In this study, we reviewed the levels of carbohydrate antigen15-3 (CA15-3), tumor specific growth factor (TSGF), carbohydrate antigen125 (CA125) and carcino embryonic antigen (CEA) both in nipple discharge and serum in 179 cases of breast lesions and their relationship with biological parameters were studied and analyzed retrospectively in order to study the Clinical and pathological value, especially in early stage of breast cancer.…”

Progression Potential of Ductal Carcinoma in situ Assessed by Genomic Copy Number Profiling

“…We used the following antibodies: anti-ER (clone 1D5, DAKO, Santa Clara, CA, USA; dilution 1: 50), anti-progesterone receptor (clone PgR636, DAKO; dilution 1: 50), anti-Ki-67 (clone MM1, Leica Biosystems Newcastle Ltd., Newcastle upon Tyne, UK; dilution 1: 100), anti-HER2 (clone 4B5, Ventana, Tucson, AZ, USA; prediluted), and anti-cytokeratin 5/6 and anti-p63 (based on a previous study) [21]. IHC analysis was optimized by evaluating serial sections with multiple antibody concentrations using a Discovery Automated Immunostainer (Ventana Medical Systems, Tucson, AZ, USA).…”