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Immunohistochemistry Markers In Breast Cancer

  • March 16,2022
  • 1 Min Read
Immunohistochemistry Markers In Breast Cancer

Immunohistochemistry (IHC) is used for diagnostic problems with breast biopsies. IHC is also  frequently used as prognostic and predictive tests.

 

IHC Marker(s)

Purpose

Cell/ antigen/ protein targeted

Interpretation

ER, PR, Her2

Predictive/ Theranostic

Hormonal markers

Immunohistochemical stains for ER, PR, and HER2 are performed for predictive and therapeutic information.

Ki-67

Prognostic

Proliferative index marker

Used to determine the prognosis of breast cancer. Also seen in differentiating Phyllodes tumour - benign, borderline, and malignant.

P63, Calponin, SMA, S100, HMWCK (high molecular weight cytokeratin)

Diagnostic

Myoepithelial cells

The presence of myoepithelial cells (MECs) in an intimate relationship with the epithelial cells of the lesion determines the difference between in-situ and invasive disease and between benign pseudo-invasive lesions and invasive carcinoma. 

Also used to categorize various papillary lesions of the breast.

E-cadherin (ECAD)

Diagnostic

Cell adhesion molecule

Used to differentiate between lobular and ductal carcinoma.

  • Ductal carcinomas (in-situ or invasive) retain membranous ECAD.

  • Lobular carcinoma cells lose ECAD staining.

Cytokeratin, EGFR

Diagnostic

Basal-like carcinoma

Basal-like carcinomas are triple-negative and show immunoreactivity for basal cytokeratin and EGFR.

Cytokeratin

Diagnostic

Sentinel node metastasis

IHC for cytokeratin stains highlight isolated tumour cells (tumour cell aggregates ≤0.2 mm).

EMA, MUC-1

Diagnostic

Micropapillary carcinoma

Identifying special types of breast carcinomas - micropapillary carcinomas can be confidently identified using EMA (or MUC-1), which demonstrates reverse.

CK7, GCDFP15, Mammaglobin, ER, CK20

Diagnostic

Systemic metastasis of breast carcinoma

In cases of morphologically similar metastatic tumours, a panel of markers are used to confirm breast primary.

PDL-1

Predictive/ Theranostic

Immune checkpoint inhibitor

In triple-negative breast cancer if cells have high expression of PDL1, then immunotherapy can be advised.

 

Triple-Negative Breast Cancers (ER-negative, PR-negative, HER2-negative):

  • Studies suggest that triple-negative breast cancers present aggressively with rapid growth and have a poorer prognosis compared with patients with other breast cancer subtypes.

  • Triple-negative breast cancer is usually high grade, and the most common histology is infiltrating ductal carcinoma, although a rare histologic subtype, medullary carcinoma, is generally triple negative. 

  • While the triple-negative clinical phenotype is heterogeneous, the basal-like molecular subtype comprises a large proportion, particularly for BRCA1-associated breast cancer.

 

Suburban Diagnostics offers a complete range of IHC and molecular testing for the diagnosis and prognostication of all types of breast cancers.

 

For any queries, contact:

  • Dr. Girish Anand Muzumdar

Consultant Histopathologist, Suburban Diagnostics

Email ID: girish.muzumdar@suburbandiagnostics.com 

Ph: 022-4027-4569 / 70

 

  • Dr. Ratika Agarwal,

HOD, Histopathology, Suburban Diagnostics

Email: drratika@suburbandiagnostics.com

Ph: 022-4027-4569 / 70

 

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