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Immunohistochemical characterization of neoplastic cells of breast origin

MariadelasMercedes Noriega1, Fernando Paesani1, Florencia Perazzo1, Néstor Lago2, Hugo Krupitzki1, Silvana Nieto1*, Alejandro Garcia1, Alejandra Avagnina1, Boris Elsner1, Valeria Cecilia Denninghoff13* and Miembro de la Carrera de Investigador del Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)13*

  • * Corresponding authors: Silvana Nieto snieto@cemic.edu.ar - Valeria C Denninghoff vdenninghoff@cemic.edu.ar - Miembro de la Carrera de Investigador del Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)

Author Affiliations

1 Centro de Educación Medica e Investigaciones Clínicas “Norberto Quirno” (CEMIC), Ciudad Autónoma de Buenos Aires, Argentina

2 GEMATECH, Ciudad Autónoma de Buenos Aires, Argentina

3 Department of Pathology, CEMIC, Galván 4102, 1st floor. C1431FWO, Ciudad Autónoma de Buenos Aires, Argentina

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Diagnostic Pathology 2012, 7:73  doi:10.1186/1746-1596-7-73

Published: 22 June 2012

Abstract

Background

After skin cancer, breast cancer is the most common malignancy in women. Tumors of unknown origin account for 5-15% of malignant neoplasms, with 1.5% being breast cancer. An immunohistochemical panel with conventional and newer markers, such as mammaglobin, was selected for the detection of neoplastic cells of breast origin. The specific objectives are: 1) to determine the sensitivity and specificity of the panel, with a special emphasis on the inclusion of the mammaglobin marker, and 2) to compare immunohistochemistry performed on whole tissue sections and on Tissue Micro-Array.

Methods

Twenty-nine metastatic breast tumors were included and assumed as tumors of unknown origin. Other 48 biopsies of diverse tissues were selected and assumed as negative controls. Tissue Micro-Array was performed. Immunohistochemistry for mammaglobin, gross cystic disease fluid protein-15, estrogen receptor, progesterone receptor and cytokeratin 7 was done.

Results

Mammaglobin positive staining was observed in 10/29 cases, in 13/29 cases for gross cystic disease fluid protein-15, in 20/29 cases for estrogen receptor, in 9/29 cases for progesterone receptor, and in 25/29 cases for cytokeratin 7. Among the negative controls, mammaglobin was positive in 2/48, and gross cystic disease fluid protein-15 in 4/48.

Conclusions

The inclusion of MAG antibody in the immunohistochemical panel for the detection of tumors of unknown origin contributed to the detection of metastasis of breast cancer. The diagnostic strategy with the highest positive predictive value (88%) included hormone receptors and mammaglobin in serial manner.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1366310812718988 webcite

Keywords:
Tumors of unknown origin; Breast; Mammaglobin; Immunohistochemistry