MYB Labeling by Immunohistochemistry is More Sensitive and Specific for Breast Adenoid Cystic Carcinoma than MYB Labeling by FISH

Justin S. Poling, Raluca Yonescu, Andrea P. Subhawong, Rajni Sharma, Pedram Argani, Yi Ning, Ashley M Cimino-Mathews

Research output: Contribution to journalArticle

Abstract

Breast adenoid cystic carcinoma (ACC) is a primary breast carcinoma that, like salivary gland ACC, displays the t(6;9) translocation resulting in the MYB-NFIB gene fusion and immunopositivity for MYB by immunohistochemistry (IHC). However, it is not well established whether MYB immunoreactivity or rearrangement can be used to support a diagnosis of ACC in a malignant basaloid or benign cribriform breast lesion. Whole sections of primary breast ACC (n=11), collagenous spherulosis (CS; n=7), and microglandular adenosis (MGA; n=5) and tissue microarrays containing 16 basal-like, triple-negative breast carcinomas (TNBC) were labeled for MYB by IHC and underwent MYB fluorescence in situ hybridization using a break-apart probe. Strong, diffuse nuclear MYB labeling was seen in 100% ACC compared with no cases of basal-like TNBC, CS, or MGA (P=0.0001). Any degree of nuclear MYB labeling was seen in 100% ACC compared with 54% of all other cases (P=0.007), with any labeling seen in 71% CS, 63% basal-like TNBC, and 0% MGA. MYB rearrangement was detected in 89% (8/9) of evaluable ACC compared with 4% (1/26) of all other evaluable cases (P=0.0001), with a rearrangement detected in 1 (7%; n=1/15) evaluable basal-like TNBC. Strong, diffuse nuclear labeling for MYB is more sensitive than MYB fluorescence in situ hybridization for breast ACC and can be used to support a diagnosis of ACC in a cribriform or basaloid lesion in the breast. However, weak and focal labeling should be interpreted with caution as it can be seen in other benign cribriform and malignant basaloid lesions.

Original languageEnglish (US)
Pages (from-to)973-979
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume41
Issue number7
DOIs
StatePublished - 2017

Fingerprint

Adenoid Cystic Carcinoma
Breast
Immunohistochemistry
Breast Neoplasms
Fluorescence In Situ Hybridization
Fibrocystic Breast Disease
Gene Fusion
Salivary Glands

Keywords

  • adenoid cystic carcinoma
  • basal-like breast carcinoma
  • collagenous spherulosis
  • microglandular adenosis
  • MYB

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

MYB Labeling by Immunohistochemistry is More Sensitive and Specific for Breast Adenoid Cystic Carcinoma than MYB Labeling by FISH. / Poling, Justin S.; Yonescu, Raluca; Subhawong, Andrea P.; Sharma, Rajni; Argani, Pedram; Ning, Yi; Cimino-Mathews, Ashley M.

In: American Journal of Surgical Pathology, Vol. 41, No. 7, 2017, p. 973-979.

Research output: Contribution to journalArticle

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abstract = "Breast adenoid cystic carcinoma (ACC) is a primary breast carcinoma that, like salivary gland ACC, displays the t(6;9) translocation resulting in the MYB-NFIB gene fusion and immunopositivity for MYB by immunohistochemistry (IHC). However, it is not well established whether MYB immunoreactivity or rearrangement can be used to support a diagnosis of ACC in a malignant basaloid or benign cribriform breast lesion. Whole sections of primary breast ACC (n=11), collagenous spherulosis (CS; n=7), and microglandular adenosis (MGA; n=5) and tissue microarrays containing 16 basal-like, triple-negative breast carcinomas (TNBC) were labeled for MYB by IHC and underwent MYB fluorescence in situ hybridization using a break-apart probe. Strong, diffuse nuclear MYB labeling was seen in 100{\%} ACC compared with no cases of basal-like TNBC, CS, or MGA (P=0.0001). Any degree of nuclear MYB labeling was seen in 100{\%} ACC compared with 54{\%} of all other cases (P=0.007), with any labeling seen in 71{\%} CS, 63{\%} basal-like TNBC, and 0{\%} MGA. MYB rearrangement was detected in 89{\%} (8/9) of evaluable ACC compared with 4{\%} (1/26) of all other evaluable cases (P=0.0001), with a rearrangement detected in 1 (7{\%}; n=1/15) evaluable basal-like TNBC. Strong, diffuse nuclear labeling for MYB is more sensitive than MYB fluorescence in situ hybridization for breast ACC and can be used to support a diagnosis of ACC in a cribriform or basaloid lesion in the breast. However, weak and focal labeling should be interpreted with caution as it can be seen in other benign cribriform and malignant basaloid lesions.",
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