A useful immunohistochemical approach to evaluate intraductal proliferative lesions of the breast and to predict their prognosis
Yoko Omi1, Tomoko Yamamoto1,3, Takahiro Okamoto2, Takao Obara2 and Makio Kobayashi1,3
Departments of 1Pathology, 2Endocrine Surgery and 3Surgical Pathology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan.
Offprint requests to: Yoko Omi, M.D, Department of Pathology, Graduate School of Medicine, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. e-mail: yomi@research.twmu.ac.jp
Summary. An examination was performed on 16 intraductal proliferative breast lesions diagnosed as intraductal papillomas (IP) or usual ductal hyperplasia (UDH), which were followed up for more than 3 years. An immunohistochemical marker panel combining myoepithelial markers, high-molecular-weight keratin (HMWK) and neuroendocrine markers was used. Two of 11 IP cases were re-evaluated as atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). These cases developed breast cancer after the first operation. One IP case showed repeated recurrences. None of the other IP and UDH cases had breast cancer or recurrence. The ADH, DCIS and the recurrent IP showing a solid growth lacked myoepithelia, but the recurrent IP expressed HMWK, immunohistochemically. Interestingly, these three lesions were weakly positive for neuroendocrine markers. All other IPs and UDHs, including lesions having solid components, were negative for neuroendocrine markers, and most of them were positive for myoepithelial markers and/or HMWK. A combination of the above immunohistochemical markers seems useful to evaluate intraductal proliferative lesions and to predict their prognosis. In particular, intraductal proliferative lesions with solid components exhibiting positivity for neuroendocrine markers should be followed up carefully to monitor breast cancer risk or recurrence. Histol Histopathol 26, 79-86 (2011)
Key words: Immunohistochemistry, Intraductal proliferative lesions, Prognosis
DOI: 10.14670/HH-26.79