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Immunoprofile of metaplastic carcinomas of the breast

Rakha, Emad A.; Coimbra, Nuno D.M.; Hodi, Zsolt; Juneinah, Enaam; Ellis, Ian O.; Lee, Andrew H.S.

Authors

EMAD RAKHA Emad.Rakha@nottingham.ac.uk
Professor of Breast Cancer Pathology

Nuno D.M. Coimbra

Zsolt Hodi

Enaam Juneinah

Andrew H.S. Lee



Abstract

Aims
Metaplastic breast carcinoma (MBC) is a rare type of breast cancer; its diagnosis in routine practice can be challenging, and may require immunohistochemical (IHC) characterization if no conventional invasive or in‐situ carcinoma is present. Previous IHC studies of MBC often had a small sample size and did not investigate the different histological subtypes. This study aimed to assess the immunoprofile of MBC subtypes in a large series.

Methods and results
A total of 172 MBC diagnosed in routine and referral practice in Nottingham during 26 years were reviewed by three breast pathologists. In addition, data on the immunoprofile of 730 MBC in 61 published studies were analysed. The antibodies to a broad spectrum of cytokeratins (AE1/AE3 and MNF116) are most frequently positive in MBC (approximately 80%). Basal cytokeratins (34βE12, CK5/6, CK14 and CK17) are positive in approximately 70%. Luminal cytokeratins (CK8/18, CK7 and CK19) are positive in approximately 30–60%. Myoepithelial markers are also frequently positive, particularly p63. Oestrogen receptor (ER), progestogen receptor (PR) and HER2 are usually all negative. CD34 (a marker often positive in phyllodes tumours) is consistently negative in MBC.

Conclusion
This study provides data on the frequency of expression of a wide range of markers in MBC based on a large number of tumours. No consistent immunophenotype was identified and no individual marker was positive in all tumours, most probably reflecting the morphological and molecular heterogeneity of this tumour class and the practical need to use a panel of different antibodies when trying to establish the diagnosis of metaplastic breast carcinoma.

Journal Article Type Article
Publication Date 2017-05
Journal Histopathology
Print ISSN 0309-0167
Electronic ISSN 1365-2559
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 70
Issue 6
Pages 975-985
APA6 Citation Rakha, E. A., Coimbra, N. D., Hodi, Z., Juneinah, E., Ellis, I. O., & Lee, A. H. (2017). Immunoprofile of metaplastic carcinomas of the breast. Histopathology, 70(6), (975-985). doi:10.1111/his.13159. ISSN 0309-0167
DOI https://doi.org/10.1111/his.13159
Keywords expression; immunohistochemistry; metaplastic; breast carcinoma; profile subtype
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/his.13159
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