Role of E-Cadherin as a Cell Marker in the Differential Diagnosis of Breast Lesions
Aims and Objectives: To diagnose and grade cases of breast cancer and evaluate their relationship to E-cadherin expression and to evaluate the role of E-Cadherin as a diagnostic and prognostic biomarker in Breast Cancer.
Material and Methods: 234 patients presenting with signs and symptoms of breast lesions were studied after a detailed history and thorough examination. Mastectomy and lumpectomy were processed for routine histopathology and immunostains for ER, PR, HER2/ NEU and E-cadherin and diagnosed and typed according to WHO classification and grading of malignant cases was done as per Modified Scarff-Bloom-Richardson grading scheme.
Results: Fibroadenoma was the most frequently diagnosed benign lesion, 60 cases (55.6%). All the benign cases showed strong and homogenous membranous positivity with intensity score of 4+. Majority of fibroadenoma cases, 8 (40.0%) showed proportion score 3+. Infiltrating ductal carcinoma (not otherwise specified) was the most frequently diagnosed malignant lesion, comprising 67 cases (53.2%), followed by residual/recurrent ductal carcinoma, in 31 cases (24.6%). Most of the Grade 1 IDC showed 3+ proportion score, with gradually decreasing score in higher grades. Relationship between grade and E-cadherin score showed a p value of 0.0059, which was statistically significant. All the 6 cases (100%) of infiltrating lobular carcinoma were negative for E-cadherin. Medullary carcinoma showed 1 case each of weak 1+ proportion score staining and 2+ Intensity score in <10% of cells.
Conclusions: Expression of E-cadherin is associated with benign or malignant nature of breast lesion, with expression stronger in benign. It can be used as diagnostic modality for subtyping breast cancers as IDC or ILC if morphology is not clear.
Keywords: Breast Carcinoma, Histopathology, Immunohistochemistry