title: Usefulness of immunocytochemistry using a Breast Marker antibody cocktail targeting P63/cytokeratin7/18/cytokeratin5/14 for fine needle aspiration of the breast: a retrospective cohort study of 139 cases.
abstract: OBJECTIVE
  The Breast Marker Cocktail from Biocare Medical comprises five antibodies recognising p63, and cytokeratins (CKs) 7, 18, 5 and 14. Immunohistochemistry using this cocktail is useful for diagnosing proliferative intraductal breast lesions. However, cytology using the cocktail has not been reported.
  
  
  METHODS
  We report 139 cases of mammary samples collected by fine needle aspiration (FNA) for which histological diagnoses were available. After cell transfer, immunocytochemistry was performed using the cocktail, and clusters of cells were classified. A cluster with no or limited CK5/14 expression (<20% of cells) was classified as a monotonous cluster. One with more than 20% of cells showing CK5/14 expression was defined as a mosaic cluster. When at least one p63-positive cell was present, we defined it as a cluster with p63. We also evaluated background p63-positive myoepithelial cell densities.
  
  
  RESULTS
  The diagnostic sensitivity and specificity for carcinomas were 97.8% (89/91) and 91.7% (11/12), respectively, using the criterion of two or more monotonous clusters lacking p63. Two false-negative cases were triple-negative cancers; one false-positive was an apocrine papilloma. The numbers of monotonous clusters with p63 differed significantly between benign lesions, ductal carcinoma in situ (DCIS)/lobular carcinoma in situ (LCIS) and invasive carcinomas (P < 0.001). The background myoepithelial cell density was significantly higher in fibroepithelial tumours than in other lesions (P < 0.001).
  
  
  CONCLUSIONS
  Immunocytochemistry using this antibody cocktail showed good sensitivity and specificity for diagnosing breast cancers. Thus, this method is useful for mammary cytology using FNA.
authors.affiliation: Division of Infectious Disease Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.|Department of Pathology, Yodogawa Christian Hospital, Osaka, Osaka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kanomata
authors.affiliation: Department of Pathology, Yodogawa Christian Hospital, Osaka, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Teramura
authors.affiliation: Chayamachi Breast Clinic, Osaka, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Wakita
authors.affiliation: Department of Surgery, Yodogawa Christian Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kunihisa
authors.affiliation: Division of Infectious Disease Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yano
authors.affiliation: Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Moriya
authors.affiliation: Division of Infectious Disease Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.|Division of Molecular Medicine and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D053547:Keratin-14 / Q000235:genetics / Q000302:isolation & purification*; D053538:Keratin-18 / Q000235:genetics / Q000302:isolation & purification*; D053555:Keratin-5 / Q000235:genetics / Q000302:isolation & purification*; D053552:Keratin-7 / Q000235:genetics / Q000302:isolation & purification*; D008565:Membrane Proteins / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000906:Antibodies; C081876:CKAP4 protein, human; D053547:Keratin-14; D053538:Keratin-18; D053555:Keratin-5; D053552:Keratin-7; D008565:Membrane Proteins
keywords: CK5/14; CK7/18; breast; fine needle aspiration; immunocytochemistry; p63