Expression of p63 immunostaining in liquid-based cytology (BD SurePath) of breast fine-needle aspiration

Masumi Osugi1, Kosei Kinoshita1, Atsuro Sugita1

  • 1Department of Pathology, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.

Insights

Adding p63 immunostaining to liquid-based cytology (LBC) significantly improves breast fine-needle aspiration cytology (FNAC) diagnostic accuracy. This method enhances the detection of myoepithelial cells, leading to more reliable results in breast lesion diagnosis.

Area of Science:

  • Pathology
  • Cytopathology
  • Oncology

Background:

  • Myoepithelial cells play a crucial role in breast lesion diagnosis.
  • Traditional methods for detecting myoepithelial cells in breast fine-needle aspiration cytology (FNAC) can be limited.
  • Liquid-based cytology (LBC) offers a potential platform for improved cellular preservation and analysis.

Purpose of the Study:

  • To evaluate the impact of p63 immunostaining on the diagnostic accuracy of breast FNAC using BD SurePath LBC slides.
  • To determine if p63 immunostaining enhances the detection of myoepithelial cells for improved breast lesion classification.

Main Methods:

  • p63 immunostaining was performed on BD SurePath liquid-based cytology (LBC) slides.
  • The study analyzed 298 breast lesions diagnosed via FNAC between July 2010 and August 2016.
  • Diagnostic accuracy metrics were compared between conventional Papanicolaou staining and LBC with p63 immunostaining.

Main Results:

  • Specific cutoff values for malignancy were established based on p63+ cell percentages and counts.
  • Malignant lesions demonstrated significantly lower percentages of p63+ clusters and single cells compared to benign lesions (P < .001).
  • LBC-p63 immunostaining significantly improved sensitivity (88.3% to 99.0%), specificity (89.1% to 99.0%), and overall diagnostic accuracy (88.6% to 99.0%) compared to Papanicolaou staining alone.

Conclusions:

  • The addition of LBC-p63 immunostaining significantly enhances the diagnostic accuracy of breast FNAC.
  • This technique provides a more reliable method for identifying myoepithelial cells, aiding in the differentiation of benign and malignant breast lesions.
Abstract

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