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. 2019 May;40(5):440-446.
doi: 10.15537/smj.2019.5.23967.

Molecular subtyping of mammary Paget's disease using immunohistochemistry

Maria Arafah  1 , Shoukat A Arain, Emad M Said Raddaoui, Asma Tulba, Fatimah H Alkhawaja, Ahlam Al Shedoukhy
Affiliations

Molecular subtyping of mammary Paget's disease using immunohistochemistry

Maria Arafah et al. Saudi Med J. 2019 May.

Abstract

Objective: To evaluate the molecular subtypes of Mammary Paget's disease (MPD) and the associated breast carcinomas.

Methods: This retrospective study was carried out at King Khalid University Hospital and King Faisal Specialist Hospital, Riyadh, Saudi Arabia. Data from MPD patient cases from January 2010 to June 2016 were reviewed. The molecular subtypes were determined based on estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) expression with immunohistochemical staining. The relative frequencies of the luminal A and B, HER2-enriched and basal-like molecular subtypes were calculated and compared for MPD and the associated breast carcinomas. Results: Among 22 patients with MPD, HER2-enriched was the most frequently occurring molecular subtype and was observed in 11 (50%) patients. Mammary Paget's disease was classified as basal-like in 5 (22.7%) patients, and luminal A and B were each detected in 3 (13.6%) patients. The molecular subtype of MPD corresponded with the subtype of the associated breast carcinoma in 18 out of 20 patients (90%).

Conclusions: The HER2-enriched subtype is the most frequently occurring molecular subtype in MPD. The molecular subtype of the associated breast carcinoma is usually similar to that of MPD. The molecular subtypes vary between MPD associated breast carcinoma and overall breast carcinoma. The HER2-enriched subtype is the most frequently occurring subtype of MPD associated breast carcinoma, while luminal subtypes are more common in overall breast carcinoma.

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Figures

Figure 1
Figure 1
Human epidermal growth factor receptor-2 (HER2)-enriched molecular subtype of MPD. A) Estrogen and B) progesterone receptors were negative and C) HER2 was overexpressed in 100% of the Paget cells (immunostaining, original magnification 20x objective).
Figure 2
Figure 2
Basal-like subtype of MPD. A) Estrogen and B) progesterone receptors and C) HER2 were negative in the Paget cells. (immunostaining, original magnification 20X objective).
Figure 3
Figure 3
Distribution of the molecular subtypes in Mammary Paget’s disease (MPD) in the present study and in MPD and breast carcinoma from the literature. HER2 - human epidermal growth factor receptor 2
See this image and copyright information in PMC

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