Medullary breast carcinoma vs. poorly differentiated ductal carcinoma: an immunohistochemical study with keratin 19 and oestrogen receptor staining

Jensen, M.L.; Kiær, H.; Melsen, F.

doi:10.1111/j.1365-2559.1996.tb01397.x

Cited by 15 publications

(4 citation statements)

References 12 publications

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“…ER and PgR expression has previously been reported in 37 of 106 [13][14][15] and seven of 16 cases of high grade conventional IDC, respectively. 13 In addition, HER2/neu overexpression was seen in 52 of 174 cases of high grade conventional IDC.…”

Section: Discussionmentioning

confidence: 99%

Frequent overexpression of epidermal growth factor receptor (EGFR) in mammary high grade ductal carcinomas with myoepithelial differentiation

et al. 2005

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Aims: To evaluate the expression of common biological markers and the epidermal growth factor receptor (EGFR) in mammary high grade ductal carcinomas with myoepithelial differentiation (DCMDs). Materials/methods: Thirty DCMDs were clinicopathologically and immunohistochemically analysed and compared with 36 control cases of high grade conventional invasive ductal carcinoma (IDC). Results: EGFR, HER2/neu, oestrogen receptor, progesterone receptor, and p53 expression was seen in 21, one, three, four, and 20 of the 30 DCMDs, compared with eight, nine, 18, 17, and five of the 36 conventional IDCs (p , 0.05), respectively. In 16 of the 30 DCMDs, metastases were found in the brain, lung, bone, and liver, within a maximum of 47 months (mean, 13.9) after initial surgery, whereas only four of the 36 conventional IDCs metastasised to the lung and bone within a maximum of 27 months (mean, 18.0) after initial surgery (p = 0.0001). There was a significant difference in disease free survival between DCMD and conventional IDC (p = 0.001). EGFR was frequently overexpressed in DCMD compared with conventional IDC, whereas the expression of HER2/neu and hormone receptors was lower in DCMD. Fluorescent in situ hybridisation revealed that the mean EGFR to chromosome 7 centromere (CEP7) ratio of the 24 DCMD cases available for evaluation was 1.03, and EGFR gene amplification was not detected in the 21 DCMD cases with EGFR overexpression. Conclusion: Immunohistochemistry for myoepithelial markers and EGFR is useful for the accurate diagnosis and molecular target treatment of high grade DCMD.

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Section: Discussionmentioning

confidence: 99%

Frequent overexpression of epidermal growth factor receptor (EGFR) in mammary high grade ductal carcinomas with myoepithelial differentiation

et al. 2005

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“…Meanwhile, there has been attempts to find immunohistochemical markers that can differentiate medullary from nonmedullary carcinomas. Earlier reports about the lack of keratin 19 in medullary carcinoma 15 were later attributed to the type of antibody used, 16–17 with most currently used keratin 19 antibodies giving a positive result in the majority of cases. 16 In this issue of Histopathology , Tot confirms the presence of keratin 19 in most medullary and atypical medullary tumours.…”

Section: Cytokeratin Profilementioning

confidence: 99%

“…All typical medullary cases and most atypical cases seem to be oestrogen receptor (ER) negative. 17 On the other hand, a strikingly low incidence of progesterone receptors 17 and c‐ erbB ‐2 positive immunostaining 19–21 and a high incidence of p53 22–23 staining were reported in medullary carcinoma. But again, none of these findings is exclusive for medullary carcinoma and most of them are common in grade 3 invasive ductal tumours which constitute the main differential diagnosis.…”

Section: Cytokeratin Profilementioning

confidence: 99%

Medullary carcinoma of the breast and BRCA1 mutation

Shousha

2000

Histopathology

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“…The concept that medullary carcinoma is a cytologically high-grade tumor has been confirmed by Ponsky et al, who found that medullary carcinomas show a strong tendency to be estrogen and progesterone receptor negative (23,24). Pedersen et al (25) and Cook et al (26) found that medullary carcinomas are more frequently aneuploid, with higher S-phase fractions than ductal carcinomas.…”

Section: Discussionmentioning

confidence: 93%

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Lazzaro¹,

Anderson²,

Kajdacsy-Balla³

et al. 2001

APPL. IMMUNOHISTOCHEM.

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of the breast has attracted attention because of its relatively good prognosis, in spite of its high cytologic grade. It has, by definition, a consistent, florid tumor infiltrating lymphocyte (TIL) population, probably the result of cytotoxic T-lymphocytes recognizing tumor cells in an HLA-DR-restricted manner. HLA-DR tends to be more highly expressed on primary medullary carcinoma cells than on ductal carcinoma cells; however, the MHC-class II antigenicity of the tumor cells themselves has not been analyzed extensively, and as yet there has been no comparative study of HLA-DR expression in medullary and ductal carcinomas metastatic to lymph nodes. Eleven cases of medullary carcinoma and 15 cases of ductal carcinoma, primaries, and respective lymph node metastases were analyzed by immunoperoxidase staining for HLA-DR and lymphocytes antigens. Polymerase chain reaction (PCR) analysis to identify HLA-DR subtypes from the paraffin blocks was performed on selected cases of primaries and nodal metastases of both tumor types. Immunoperoxidase staining for HLA-DR antigen revealed a marked difference in antigen expression between medullary and ductal carcinomas. In the medullary carcinomas, the mean percentage of cells staining for HLA-DR was 74.5% in the primary tumors and 67.3% in the nodal metastases. For the ductal carcinomas, the mean percentage of cells staining was 17.7% in the primaries and 7% in the metastases. There was a tendency for the level of HLA-DR expression to remain high in medullary carcinoma metastatic to nodes, whereas whatever HLA-DR was present within ductal primaries tended to diminish when cells metastasized to regional nodes. PCR analysis of the HLA-DR within the two tumor types revealed no emerging subtype or variant that could be associated with either the medullary or the ductal carcinomas. Medullary carcinoma cells express much greater quantities of HLA-DR, on the whole, than ductal carcinomas. Expression of HLA-DR is retained on medullary carcinoma cells that have spread to lymph nodes, whereas the smaller quantities of HLA-DR present within ductal primaries tend to diminish even further when the tumor cells are found in lymph nodes. No discernible HLA-DR mutations or predominant subtypes emerged on PCR analysis, and the authors therefore conclude that it is the quantity and not the quality of HLA-DR expression in medullary carcinoma that maintains the characteristic TIL infiltrate, not seen in ductal carcinomas.

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Medullary breast carcinoma vs. poorly differentiated ductal carcinoma: an immunohistochemical study with keratin 19 and oestrogen receptor staining

Cited by 15 publications

References 12 publications

Frequent overexpression of epidermal growth factor receptor (EGFR) in mammary high grade ductal carcinomas with myoepithelial differentiation

Frequent overexpression of epidermal growth factor receptor (EGFR) in mammary high grade ductal carcinomas with myoepithelial differentiation

Medullary carcinoma of the breast and BRCA1 mutation

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