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Published on: December 5, 2017
[Diagnostic immunohistochemistry of breast epithelial lesions]
André J Balaton1, Jean-Marc Guinebretière, Frédérique Penault-Llorca
1Centre de pathologie, 20 avenue de la Gare, 91570 Bièvres. bievres6@club-internet.fr
Insights
Immunohistochemistry (IHC) supports pathologists in diagnosing challenging breast lesions, especially with smaller biopsies from screening programs. IHC aids in differentiating benign from malignant conditions and classifying specific breast cancer subtypes.
Area of Science:
- Pathology
- Oncology
- Histology
Context:
- Mammography screening and needle biopsies yield smaller samples, increasing diagnostic challenges for pathologists.
- Preinvasive breast lesions are increasingly encountered, requiring precise diagnostic methods.
- Traditional H&E staining may be insufficient for complex or subtle breast pathology cases.
Purpose:
- To review the primary applications of diagnostic immunohistochemistry (IHC) in breast pathology.
- To highlight the utility of IHC in overcoming diagnostic difficulties associated with small biopsy samples.
- To provide guidance on using IHC for specific diagnostic scenarios in breast lesion evaluation.
Summary:
- Immunohistochemistry (IHC) serves as a crucial adjunct to histopathology in breast cancer diagnosis.
- Key applications include distinguishing benign from malignant lesions, differentiating hyperplasia from carcinoma, and identifying specific tumor subtypes.
- IHC is particularly valuable in evaluating small biopsies and preinvasive lesions encountered in modern breast screening programs.
- It aids in confirming malignancy, distinguishing between lobular and ductal carcinomas, and diagnosing metastatic breast cancer.
Impact:
- Enhances diagnostic accuracy in breast pathology, particularly for challenging cases.
- Improves patient management by enabling precise classification of breast lesions.
- Supports the effective use of immunohistochemistry in routine diagnostic practice for breast conditions.
- Facilitates earlier and more accurate diagnosis of breast cancer and its subtypes.
Abstract:
Routine H&E sections are sufficient for diagnosis of the vast majority of breast lesions. Development of mammography mass screening and widespread use of preoperative needle biopsy diagnosis have led to diagnostic difficulties for pathologists. The samples are smaller and more and more preinvasive lesions are seen. It is mainly in those situations that immunohistochemistry (IHC) can efficiently back up histopathology. This review details the main applications of diagnostic IHC in breast pathology. The advantages of IHC in various clinical situations are discussed diagnosis of benign breast lesions mimicking malignancy, distinction between simple type ductal hyperplasia and atypical hyperplasia or ductal in situ carcinoma, confirmation of malignancy, distinction between lobular and ductal carcinoma, identification of specific histological subtypes, and, diagnosis of intra and extra mammary metastases.
