Diagnostic Utility of p63, Ck5/6 and ER in Papillary Neoplasms of Breast
DOI:
https://doi.org/10.70749/ijbr.v3i5.2974Keywords:
Diagnostic Utility of p63, Ck5/6 and ER in Papillary Neoplasms of BreastAbstract
Background: Papillary neoplasms of breast consist of broad spectrum of lesions ranging from intraductal papilloma to papilloma with ADH/DCIS, papillary DCIS, encapsulated papillary carcinoma, solid papillary carcinoma(insitu/invasive) and invasive papillary carcinoma. It is very challenging to classify these lesions as benign or malignant as they have similar papillary architecture. The classification as benign or malignant depends on the presence or absence of myoepithelial layer and epithelial atypia. Various myoepithelial and epithelial markers are used for this purpose. However, certain markers are more specific and helpful than others. In this study, we are evaluating the diagnostic utility of myoepithelial markers (p63 and CK5/6) and epithelial marker (ER) in the various papillary lesions, so the timely diagnosis and early management can be done in better way. Material and Methods: In this study, we determine the expression of myoepithelial immunohistochemical markers (p63 and ck5/6) and epithelial marker (ER) in benign and malignant papillary lesions of breast (201 cases) constituting of intraductal papilloma (142 cases), papillary DCIS (5 cases), encapsulated papillary carcinoma (15 cases), solid papillary carcinoma in situ (6 cases), invasive solid papillary carcinoma (15 cases) and invasive papillary carcinoma (15 cases). Results: Ck5/6 shows 99%, p63 shows 98.51% and ER shows 99% diagnostic accuracy in all the cases of intraductal papillomas. P63 shows 100% diagnostic accuracy in invasive solid papillary carcinoma while in other atypical and malignant lesions it shows 99.50% diagnostic accuracy. Ck5/6 shows 100% diagnostic accuracy in papillary DCIS, invasive solid and invasive papillary carcinoma, 99.50% in encapsulated papillary carcinoma and 99% in solid papillary carcinoma insitu. While ER has 100% diagnostic accuracy in papillary DCIS and solid carcinoma in situ, 99.50% in encapsulated papillary carcinoma, 99% in invasive papillary carcinoma and 94.4% in invasive solid papillary carcinoma. Conclusion: Combined panel of myoepithelial and epithelial immunohistochemical markers is required to differentiate various benign and malignant papillary lesions with diagnostic accuracy, timely diagnosis and early treatment.
Downloads
References
1. Jamidi, S. K., & Tse, G. M. (2025). Papillary lesions of the breast. Diagnostic Histopathology, 31(12), 707-714.
https://doi.org/10.1016/j.mpdhp.2025.10.004
2. Jassar, A. (2017). Papillary lesions in breast pathology practice: Diagnostic challenges and practical Approach-A six year experience from a tertiary care hospital. International Journal of Innovative Research in Medical Science (IJIRMS), 2(5), 755-62.
3. The Crucial Role of IHC in Papillary Breast Lesions – ISIMM. (2024, October 18). Isimm.org.
https://isimm.org/2024/10/18/the-crucial-role-of-ihc-in-papillary-breast-lesions/
4. Tse, G. M., Ni, Y.-B., Tsang, J. Y. S., Shao, M.-M., Huang, Y.-H., Luo, M.-H., Lacambra, M. D., Yamaguchi, R., & Tan, P.-H. (2014). Immunohistochemistry in the diagnosis of papillary lesions of the breast. Histopathology, 65(6), 839–853.
https://doi.org/10.1111/his.12453
5. Thai, J. N., Vickery, J., Baris Boyraz, Crowley, C., Saksena, M. A., Hong, X., Makarenko, V. V., Tulecke, M. A., McIntire, P. J., & Veerle Bossuyt. (2025). Papillary Neoplasms of the Breast: WHO Classification, Multimodality Imaging, and Radiologic-Pathologic Correlation. Radiographics, 45(8).
https://doi.org/10.1148/rg.240091
6. Kulka, J., Madaras, L., Floris, G., & Lax, S. F. (2021). Papillary lesions of the breast. Virchows Archiv, 480(1), 65-84.
https://doi.org/10.1007/s00428-021-03182-7
7. Bassyoni, O., Elshawarby, Z., & Abostate, A. (2023). Diagnostic significance of Immunohistochemistry in papillary breast neoplasms. Benha Medical Journal, 40(2), 516-527.
https://doi.org/10.21608/bmfj.2023.223495.1854
8. Tan, P. H., Ellis, I., Allison, K., Brogi, E., Fox, S. B., Lakhani, S., Lazar, A. J., Morris, E. A., Sahin, A., Salgado, R., Sapino, A., Sasano, H., Schnitt, S., Sotiriou, C., Van Diest, P., White, V. A., Lokuhetty, D., & Cree, I. A. (2020). The 2019 World Health Organization classification of tumours of the breast. Histopathology, 77(2), 181-185.
https://doi.org/10.1111/his.14091
9. Nuñez, D. L., González, F. C., Ibargüengoitia, M. C., Fuentes Corona, R. E., Hernández Villegas, A. C., Zubiate, M. L., Vázquez Manjarrez, S. E., & Ruiz Velasco, C. C. (2020). Papillary lesions of the breast: A review. Breast Cancer Management, 9(4).
https://doi.org/10.2217/bmt-2020-0028
10. Prabhu, S. D., Rai, H. S., Nayak, R., Naik, R., & Jayasheelan, S. (2023). Study of the Immunohistochemical expression of p63 in benign lesions and carcinoma of the breast at a tertiary hospital in South India. Cureus.
https://doi.org/10.7759/cureus.48557
11. Aden, D., Afroze, N., Sufian, Z., Khan, A. I., Khan, T., & Aziz, M. (2022). The role of p63 Myoepithelial cell marker in papillary lesions of the breast. International Journal of Clinical and Diagnostic Pathology, 5(1), 72-76.
https://doi.org/10.33545/pathol.2022.v5.i1b.455
12. Das, A.; S, N. B.; C, V.; Pokhrel, B. Role of CK5/6 in Breast Tumors: IHC Insights into Benign and Malignant Differentiation. Eur. J. Cardiovasc. Med. 2025, 15, 590–595.
https://doi.org/10.5083/ejcm/25-06-92
13. Pathmanathan, N., Albertini, A., Provan, P. J., Milliken, J. S., Salisbury, E. L., Bilous, A. M., Byth, K., & Balleine, R. L. (2010). Diagnostic evaluation of papillary lesions of the breast on core biopsy. Modern Pathology, 23(7), 1021-1028.
https://doi.org/10.1038/modpathol.2010.81
14. Bavikar, R., Deshmukh, S., & Khande, T. (2017). Spectrum of papillary lesions of breast with immunohistochemistry and review of literature. Indian Journal of Pathology and Oncology, 4(1), 52-55.
15. Kader, T., Elder, K., Zethoven, M., Semple, T., Hill, P., Goode, D. L., Thio, N., Cheasley, D., Rowley, S. M., Byrne, D. J., Pang, J., Miligy, I. M., Green, A. R., Rakha, E. A., Fox, S. B., Mann, G. B., Campbell, I. G., & Gorringe, K. L. (2020). The genetic architecture of breast papillary lesions as a predictor of progression to carcinoma. npj Breast Cancer, 6(1).
https://doi.org/10.1038/s41523-020-0150-6
16. Rakha, E. A., & Ellis, I. O. (2018). Diagnostic challenges in papillary lesions of the breast. Pathology, 50(1), 100-110.
https://doi.org/10.1016/j.pathol.2017.10.005
17. G, Dr. S. J.; C, Dr. N.; Prabhala, S., & Deshpande, A. K. (2020). Efficacy of immunohistochemistry in diagnosing papillary lesions of the breast. International Journal of Clinical and Diagnostic Pathology, 3(1), 222-226.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
