Ductal or Lobular? Narrow your Diagnosis

Making the distinction between ductal carcinoma in situ (DCIS) and lobular carcinoma (LCIS) can be difficult in some situations. The proper distinction between atypical lobular hyperplasia, lobular carcinoma in situ and low-grade ductal carcinoma in situ is critical for patient management.¹ While histology is the first line of distinction, subsequent immunostains are highly useful.

Studies have shown E-cadherin, a negative membrane marker for lobular neoplasia, is useful in the distinction of ductal neoplasia vs. lobular; however, as a negative marker for lobular carcinoma, it can be difficult to interpret, particularly in challenging cases1. Dr. Schnitt, chief of breast oncologic pathology at Dana Farber/ Brigham and Women’s Cancer Center, suggests that if the pathologist is concerned that the E-cadherin staining is aberrant, “then doing p120 and beta-catenin stains may help clarify… because E-cadherin, p120 catenin, and beta-catenin are all part of the membrane adhesion complex. ‘And even when E-cadherin is expressed aberrantly, there may be abnormal expression of beta-catenin and p120 catenin. And that often helps determine whether or not the E-cadherin staining you are seeing is real or aberrant.’”²

To aid in the differentiation, Biocare Medical formulated a multiplexing cocktail of p120 + E-cadherin that may give further clarification in the separation of low-grade ductal carcinoma in situ from lobular neoplasia. “Diagnostically, p120 catenin was particularly useful in identifying early lesions of lobular neoplasia.”¹ Therefore, this cocktail may enable the identification and the extent of the lobular lesions, helping provide a more accurate diagnosis, while preserving precious tissue from the needle biopsy.

Interested in testing p120 + E-cadherin in your lab? Contact Biocare Medical to learn more about this cocktail at 800-799-9499 or click the link here: https://biocare.net/product/p120-e-cadherin-antibody/

1. Dabbs DJ, Bhargava R, Chivukula M. Lobular versus ductal breast neoplasms: the diagnostic utility of p120 catenin. Am J Surg Pathol. 2007 Mar; 31(3):427-37.
2. vLusky, K., LCIS variant and DCIS: tips on telling them apart. CAP Today. April 2018. 32 (4): 12-15.