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Distinguishing medullary carcinoma of the breast from high‐grade hormone receptor‐negative invasive ductal carcinoma: an immunohistochemical approach
Author(s) -
Flucke Uta,
Flucke Maria Theresia,
Hoy Ludwig,
Breuer Elisabeth,
Goebbels Rolf,
Rhiem Kerstin,
Schmutzler Rita,
Winzenried Helene,
Braun Michael,
Steiner Susanne,
Buettner Reinhard,
Gevensleben Heidrun
Publication year - 2010
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2010.03555.x
Subject(s) - immunohistochemistry , myoepithelial cell , pathology , vimentin , breast cancer , medullary cavity , ductal carcinoma , hormone receptor , carcinoma , progesterone receptor , medicine , estrogen receptor , cancer
Flucke U, Flucke M T, Hoy L, Breuer E, Goebbels R, Rhiem K, Schmutzler R, Winzenried H, Braun M, Steiner S, Buettner R & Gevensleben H
(2010) Histopathology 56, 852–859
Distinguishing medullary carcinoma of the breast from high‐grade hormone receptor‐negative invasive ductal carcinoma: an immunohistochemical approach Aims: 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. Methods and results: 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‐2α, AP‐2γ). A significantly higher proportion of IDCs displayed increased expression of CK7, AP‐2α and HER2 in contrast to MCs (CK7: 91% of IDCs versus 77% of MCs; AP‐2α: 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). Conclusions: Hormone receptor‐negative high‐grade IDCs are significantly associated with luminal differentiation, Her2 and AP‐2α overexpression, whereas MCs tend to display myoepithelial features. Markers analysed in this study are of diagnostic value regarding the differential diagnosis of MCs.