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