Immunohistochemistry in Breast Pathology - Part 2a -
Supplementary Material

Malignant and benign tubular proliferations

Further example of a tricky tubular carcinoma and the use of myoepithelal markers to confirm invasive malignancy:

Core biopsy - invasive carcinoma with tubular features. In the lower left photomicrogaph red arrows point to benign structures and blue arrows to malignant.
Low power - The tubules are more randomly scattered than in a radial scar and do not appear to be pinched in the middle Absent CK 5/6 myoepithelal staining in much of the central area of this secdtion
Medium power H&E of tubular carcinoma - there is no trace of a myoepithelial layer around these tubules CK 5/6 - Note absent myoepithelial layer around tumour acini and an entrapped normal/hyperplastic duct showing an intact layer

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Further images showing the value of myoepithelial markers in confirming a diagnosis of nipple adenoma.

Low power view of P63 stain showing intact myoepithelial layer throughout lesion

P63 staining in nipple adenoma

Medium power view of CK5/6 stain in nipple adenoma - variable but convincing positive staining

CK 5/6 staining in nipple adenoma

High power view of CK 5/6 stain in nipple adenoma (florid papillomatosis)

CK 5/6 staining in nipple adenoma

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