role of ihc in breast pathology - mme...
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Role of IHC in Breast Pathology
ESPC Breast Workshop 2017 14 December
Outline
◼Diagnostic
▪ Benign vs malignant ductal lesions
▪ Ductal vs lobular lesions
▪ Papillary lesions
◼Prognostic
Young F, Mass Core Biopsy
VOTE: Diagnosis
1. Benign2. Atypical3. In situ4. Malignant
◼Mastectomy done
VOTE: What stain would you order
1. none2. basal myoepithelial, i.e. p633. ER/PR4. CerbB2
DCIS in Adenosis
◼DCIS◼ Involving adenosis
ME MarkersLiu. Immunohistochemistry in breast pathology. Arch Pathol Lab Med. 2014;138:1629
S100 vs p63
Her2 in DCIS vs ADH
◼15-20% of invasive ca◼Up to 60% in DCIS
DCIS
Margin
CerbB2
Lobular Lesions
◼Vs ductal◼Vs myoepithelial
Papillary Lesions
50 F Subareolar
VOTE
1. Benign2. Atypical3. In situ4. Invasive
Solid PapillaryZhao et al. Diagnostic Role of Immunohistochemistry in the Evaluation of Breast Pathology Specimens. Arch Pathol Lab Med. 2014;138:16
Papillary LesionsPeng et al. Update on Immunohistochemical Analysisin Breast LesionsArch Pathol Lab Med. 2017;141:1033
Prognostic Markers
Ki67
2nd tumor; multifocal
Well Differentiated
IHC Surrogates for MolecularTang and Tse. Immunohistochemical Surrogates for Molecular Classification of Breast Carcinoma: A 2015 Update. Arch Pathol Lab Med. 2016;140:806
IHC Surrogates
Molecular IHC: Basal Like Breast CALeidy et al. Basal-Like Breast Cancer: Update on Clinicopathologic, Immunohistochemical, and Molecular FeaturesArch Pathol Lab Med. 2014;138:37
Novel MarkerJensen et al. Diagnosis of Basal-Like Breast Cancer Using aFOXC1-Based Assay. JNCI J Natl Cancer Inst (2015) 107: djv148
Allred vs FOXC1
DSS Curves: PAM50 vs FOXC1
H&E is King (Queen Sheikha)!
References
◼Peng et al, Arch Pathol lab Med 2017. 141:1033
◼Ray et al. Cancer Res 70:10, 2010◼Liu. Arch Pathol Lab Med 2014:138:1629◼Zhao et al. Arch Pathol Lab Med 2014:138:16◼Tang and Tse. Arch Pathol Lab Med 2016:
140:806
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