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Mesothelial markers in high-grade breast carcinoma
Edwina E Duhig1, Lydia Kalpakos, Ian A Yang
1Department of Anatomical Pathology, Pathology Queensland, The Prince Charles Hospital, Chermside, Queensland, Australia. Edwina_Duhig@health.qld.gov.au
Histopathology
|November 19, 2011
Summary
Basal-like breast carcinomas share immunophenotypic markers with mesothelial cells, complicating diagnosis. Certain mesothelial markers like WT1 and thrombomodulin can help differentiate these cancers.
Area of Science:
- Oncology
- Pathology
- Immunohistochemistry
Background:
- Molecular profiling classifies breast carcinomas into subtypes, including basal-like carcinomas.
- Basal-like breast carcinomas often exhibit oestrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and human epidermal growth factor receptor 2 (HER2)-negative status, alongside cytokeratin (CK)5/6 positivity.
- This immunophenotype shows overlap with mesothelial cells, posing diagnostic challenges.
Purpose of the Study:
- To investigate the expression of mesothelial markers in high-grade breast carcinomas.
- To determine if mesothelial markers can aid in differentiating basal-like breast carcinomas from mesothelial neoplasms.
Main Methods:
- Immunohistochemistry was performed on 23 basal-like breast carcinomas and 30 high-grade breast carcinomas with variable ER, PR, and HER2 expression.
- The study assessed the incidence of staining for CK5/6, CK14, calretinin, Wilms' tumour 1 (WT1), thrombomodulin, and epithelial membrane antigen.
- Statistical analysis was employed to evaluate the association of marker expression with tumour subtypes.
Main Results:
- CK14 staining was more specifically associated with triple-negative tumours compared to CK5/6.
- Calretinin positivity showed a statistical association with basal-like breast carcinomas.
- WT1 and thrombomodulin expression was infrequent and primarily observed in a small subset of non-basal carcinomas.
Conclusions:
- An overlap exists between the immunophenotype of mesothelial cells and basal-like breast carcinomas.
- Positive calretinin and CK5/6 are not specific markers and can be present in both cell types.
- Negative ER and PR in basal carcinomas may lead to misdiagnosis; however, negative mesothelial markers like WT1 and thrombomodulin can aid in accurate diagnosis.
