A Study of Myoepithelial Cells in Fine Needle Aspirates from Breast Lump Using Antibody to p63
Keywords:
breast aspirates, myoepithelial cells, p63 antibody
Abstract
Background: - Myoepithelial cells of the mammary gland are considered to be a key in distinguishing benign from malignant disease in fine-needle aspiration cytology (FNAC). p63 decorates the nuclei of myoepithelial cells. In view of this, present study was undertaken to study the difference in number of myoepitheal cells in various breast lesions using anti p63 immunocytochemistry.Methods: This study was conducted on 50 patients presenting with breast lump. FNA was done, smears prepared were stained with May Grunwald Giemsa and subjected to immunocytochemistry for p63. MGG stained smears were subjected to quantitative estimation of myoepithelial cells per 1000 ductal cells. Percentage of cell clusters showing p63 positive cells were noted. Only the nuclear immunoreactivity for p63 was considered specific.Result: Maximum number of cases (26) were in 20 – 29 years age group (55.3%).The mean number of myoepithelial cells in the benign lesions was 196.8 while ductal carcinoma had a mean of 5.8.The difference between the mean of myoepithelial cells/1000 ductal cells was found to be statistically significant (t- value 4.51 and p-value .000048). The difference in p63 immunostaining between benign and malignant lesions was also found to be statistically significant (for positivity of p63 at 0% and > 75% p value <0.001).Conclusion: We hereby conclude that myoepithelial cells are a key to distinguish benign from malignant lesions in FNAC. Their sensitivity is increased by staining with p-63 antibody. We also conclude that presence of more than 74% positive cell clusters is strongly suggestive of benign lesions. DOI: 10.21276/apalm.2017.1092References
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18. Barbareschi M, Pecciarini L, Cangi MG et al. p63, a p53 homologue, is a selective nuclear marker of myoepithelial cells of the human breast. Am J Surg Pathol. 2004; 28 :1506-12.
19. Stefanou D, Batistatou A, Nonni E. et al. P63 expression in benign and malignant breast lesions. Histol Histopathol 2004; 19:465-471.
20. Koker MM, Kleer CG. p63 expression in breast cancer: a highly sensitive and specific marker of metaplastic carcinoma. Am J Surg Pathol. 2004; 28 :1506-1512.
2. Chianakwalam CI, Bates T: Diagnosis and management of breast lump. Surgery (2001); 19:73-76.
3. Nagao T, Bando Y, Sasa M, et al : False-positives in fine needle aspiration cytology of breast disease can be reduced with p63 immunostaining. Anticancer Res2006;26:4373-7.
4. Jayaram G, Alhady SF ,Yip CH . Cytological analysis of breast lesions: A review of 780 cases. Malaysian J Pathol 1996; 18: 81-7.
5. Jarwani PB, Patel DC, Patel SM, et al. Fine needle aspiration cytology in a palpable breast lump GCSMC J Med Sci2013;2(2): 12-16.
6. Modi P, Oza H, Bhalodia J. FNAC as preoperative diagnostic tool for neoplastic and non-neoplastic breast lesions: A teaching hospital experience. National Journal of Medical Research 2014; 4(4): 274-278.
7. Singh A, Haritwal A, Murali B . Pattern of breast lumps and diagnostic accuracy of fine needle aspiration cytology, A hospital based study from Pondicherry, India. The Internet Journal of Pathology. 2010;11:2.
8. Chaudhury S, Alam MK, Haque MS. The role of FNAC in diagnosis of breast disease at different ages -208 cases. Journal of Bangladesh College of Physicians and Surgeons 2012; 30(3): 137-140.
9. Likhar KS, Fatima A, Hazari R A, et al. Diagnostic role of FNAC in breast lesions IJRRMS 2013;3(1):12-14.
10. Thakkar B, Parekh M, Trivedi NJ et al. Role of fine needle aspiration cytology in palpable breast lesions and its correlation with histopathological diagnosis .National Journal of Medical Research 2014;4(4):283-288.
11. Rahman MZ, Islam S. Fine needle aspiration cytology of palpable breast lump: A study Of 1778 cases. Surgery: Current Research 2013 S12: 001.
12. Bukhari MH, Arshad M, Jamal S et al. Use of fine needle aspiration in the evaluation of breast lumps. Pathology Research International. 2011; 1-10.
13. Ballo MS, Sneige N. Can core needle biopsy replace fine-needle aspiration, cytology in the diagnosis of palpable breast carcinoma : A comparative study of 124 women, Cancer 1996; 78: 773-7.
14. Hussain MT. Comparison of fine needle aspiration cytology with excision biopsy of breast lump. J Coll Physicians Surg Pak 2005:15:211-4.
15. Pattari SK, Dey P, Gupta SK, et al. Myoepithelial cells: Any role in aspiration cytology smears of breast tumours. Cytojournal 2008; 5:9.
16. Harton AM, Wang HH, Schnitt SJ, et al. p63 Immunocytochemistry improves accuracy of diagnosis with fine-needle aspiration of the breast. Am J Clin Pathol 2007; 128: 80-5.
17. Aiad HAS, Abd El-Halim Kandil M . Diagnostic role of p63 immunostaining in fine needle aspiration cytology of different breast lesions. Acta Cytol 2011; 55149-57
18. Barbareschi M, Pecciarini L, Cangi MG et al. p63, a p53 homologue, is a selective nuclear marker of myoepithelial cells of the human breast. Am J Surg Pathol. 2004; 28 :1506-12.
19. Stefanou D, Batistatou A, Nonni E. et al. P63 expression in benign and malignant breast lesions. Histol Histopathol 2004; 19:465-471.
20. Koker MM, Kleer CG. p63 expression in breast cancer: a highly sensitive and specific marker of metaplastic carcinoma. Am J Surg Pathol. 2004; 28 :1506-1512.
Published
2017-02-19
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