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Distinct Uroplakin II Staining Pattern in Apocrine Breast Carcinoma.

Derek M van Pel1, Jennifer Pors2, Eddie Yuen2

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|October 13, 2022
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Summary
This summary is machine-generated.

Uroplakin II (UPII) can help distinguish apocrine breast cancers from urothelial carcinoma. This specific staining pattern in breast tissue aids in avoiding diagnostic errors, improving accuracy in cancer subtyping.

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Area of Science:

  • Oncology
  • Pathology
  • Immunohistochemistry

Background:

  • Uroplakin II (UPII) is a specific marker for urothelial carcinoma.
  • UPII can also stain apocrine-differentiated breast carcinoma, posing a diagnostic challenge due to shared markers like CK7 and GATA3 with urothelium.
  • Distinguishing between urothelial carcinoma and breast carcinoma subtypes is critical for accurate diagnosis and treatment.

Purpose of the Study:

  • To investigate the utility of Uroplakin II (UPII) as a diagnostic marker in triple-negative breast cancer.
  • To differentiate between urothelial carcinoma and apocrine-differentiated breast carcinoma using UPII staining patterns.
  • To assess the specificity of UPII staining in various breast tissue types and compare it with urothelial carcinoma.

Main Methods:

  • A cohort of triple-negative breast cancer cases were stained with Uroplakin II (UPII) antibody.
  • Immunohistochemical staining patterns of UPII in apocrine carcinoma, nonapocrine triple-negative breast cancer, apocrine metaplasia, and normal skin apocrine glands were analyzed.
  • Staining patterns were compared with those observed in urothelial carcinoma.

Main Results:

  • Uroplakin II (UPII) showed positive staining in 38.9% (7/18) of apocrine breast carcinoma cases.
  • The staining pattern in apocrine carcinoma was coarse and granular cytoplasmic, distinct from the diffuse cytoplasmic staining seen in urothelial carcinoma.
  • UPII was negative in all nonapocrine triple-negative breast cancer cases and positive in apocrine metaplasia and normal skin apocrine glands with a similar granular pattern.

Conclusions:

  • The distinct subcellular localization and staining pattern of Uroplakin II (UPII) in apocrine breast lesions can help resolve diagnostic pitfalls.
  • UPII serves as a valuable marker to differentiate apocrine breast carcinoma from urothelial carcinoma.
  • This finding enhances diagnostic accuracy in challenging cases involving breast and urothelial tissues.