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PAX8 Expression in Breast Cancer.

Shaolei Lu1, Evgeny Yakirevich, Jesse Hart

  • 1Department of Pathology and Laboratory Medicine, Lifespan Medical Center and Brown University Alpert School of Medicine, Providence, RI.

Applied Immunohistochemistry & Molecular Morphology : AIMM
|November 19, 2020
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Summary

PAX8 immunohistochemistry is rarely positive in breast cancer, typically appearing as weak to moderate staining in high-grade, triple-negative invasive ductal carcinomas. This finding is crucial for accurate diagnosis of breast tumors.

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Area of Science:

  • Oncology
  • Pathology
  • Immunohistochemistry

Background:

  • PAX8 protein is a marker for renal, thyroid, and Müllerian carcinomas.
  • Metastatic tumors in the breast can be misdiagnosed as primary breast lesions.
  • PAX8 expression in primary breast cancer is not well-characterized.

Purpose of the Study:

  • To evaluate the frequency and pattern of PAX8 expression in invasive breast carcinoma.
  • To determine the utility of PAX8 immunohistochemistry in diagnosing breast cancer.

Main Methods:

  • Analysis of 266 invasive breast carcinoma cases using tissue microarrays and whole tissue sections.
  • Immunohistochemical staining with a PAX8 monoclonal antibody.
  • Assessment of staining intensity (weak, moderate, strong) and extent (focal, diffuse).

Main Results:

  • PAX8 was expressed in 6.02% (16/266) of invasive breast carcinomas.
  • All positive cases showed weak to moderate staining intensity and were high-grade (Grade III) invasive ductal carcinomas.
  • PAX8 expression was predominantly observed in triple-negative breast cancers.

Conclusions:

  • PAX8 expression is infrequent in breast cancer and typically associated with high-grade, triple-negative subtypes.
  • Weak to moderate PAX8 immunoreactivity does not exclude a mammary origin.
  • Clinical and pathological data are essential for accurate diagnosis when PAX8 is present.