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Optimization, Design and Avoiding Pitfalls in Manual Multiplex Fluorescent Immunohistochemistry
Published on: July 26, 2019
Avoiding "False Positive" and "False Negative" Immunohistochemical Results in Breast Pathology
1The Ohio State University, Columbus, Ohio, USA.
Insights
This review highlights challenges in interpreting immunohistochemistry (IHC) for breast pathology. It focuses on pitfalls in diagnosing various breast cancers and assessing prognostic markers.
Area of Science:
- Pathology
- Oncology
- Immunohistochemistry
Background:
- Immunohistochemistry (IHC) is crucial for breast pathology diagnosis and prognosis.
- Most IHC applications are straightforward, but uncommon scenarios present interpretation challenges.
Purpose of the Study:
- To review challenging areas in breast pathology IHC interpretation.
- To address diagnostic and prognostic/therapeutic marker interpretation pitfalls.
Main Methods:
- Literature review focusing on specific IHC marker applications.
- Discussion of challenging differential diagnoses in breast pathology.
Main Results:
- Interpretation of myoepithelial cell markers for distinguishing benign vs. in situ vs. invasive carcinoma.
- Differentiating lobular from ductal carcinoma using lobular cell markers.
- Diagnosing metaplastic carcinoma with cytokeratin and other markers.
- Identifying primary breast carcinoma using tissue origin markers.
- Challenges in interpreting prognostic and predictive IHC markers.
Conclusions:
- Accurate IHC interpretation is vital for correct breast cancer diagnosis and treatment.
- Awareness of specific pitfalls in IHC analysis is necessary for pathologists.
- Further understanding of challenging IHC scenarios can improve patient management.
Abstract:
Immunohistochemistry (IHC) plays an important role in the evaluation of breast pathology specimens to provide both diagnostic and prognostic/therapeutic information. Although most IHCs used in breast pathology can be easily interpreted, pitfalls do exist, especially in some uncommon scenarios. This review intends to focus on the challenging areas such as the interpretation of myoepithelial cell markers in differentiating benign proliferation and in situ carcinoma from invasive carcinoma, lobular cell markers in differentiating lobular from ductal carcinoma, cytokeratin and other markers in diagnosing metaplastic carcinoma, and breast tissue origin markers in diagnosing breast primary carcinoma. The challenges in interpreting prognostic and predictive markers will be also discussed.
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