ILC and the D2-40 marker

mymountain

 Hi All,

I ran across this article and had never heard of the D2-40 marker.  Just wanted to share it and get your thoughts.  Has anyone had this done as part of their pathology?

MM 

Invasive Lobular Carcinoma of the Breast: Role of Endothelial Lymphatic Marker D2-40

Jordan Laser, Joan Cangiarella, Baljit Singh, Jonathan Melamed, Luis Chiriboga, Herman Yee and Farbod Darvishian
New York University School of Medicine, New York, New York

Address correspondence to Farbod Darvishian, M.D., New York University School of Medicine, Tisch Hospital, 530 First Avenue SK10U, New York, NY 10016, USA; tel 212 263 0138; fax 212 263 5509; e-mail: farbod.darvishian@nyumc.org or farbodarv@yahoo.com .

Lymphovascular invasion (LVI) of breast cancer is an independentadverse prognosticator that is associated with increased regionaland distant tumor recurrence. LVI is infrequently encounteredin invasive lobular carcinoma when compared to invasive ductalcarcinoma. We employed D2-40 antibody, a novel marker for lymphaticendothelial cells, in an attempt to enhance the detection ofLVI in invasive lobular carcinomas. We identified 78 patientswith invasive lobular carcinoma with known axillary status,who were studied between 2003 and 2006. D2-40 antibody was appliedto one representative paraffin block from each case and theresults were compared to LVI on routine histology. LVI was identifiedin 12 (15%) and 19 (24%) cases by routine histology and D2-40antibody, respectively. Eleven of 12 patients (92%) with LVIidentified by routine histology had axillary nodal metastasiscompared to 14 of 19 patients (74%) with LVI identified by D2-40antibody. LVI was missed by routine histology in 8 cases (10%).D2-40 antibody enhanced the identification of LVI by 9% in nodenegative patients. D2-40 antibody increased the identificationof LVI by 12% in classic invasive lobular carcinoma. In conclusion,D2-40 antibody staining may be useful as an adjunct in detectingLVI in invasive lobular carcinoma, especially in node-negativepatients with the classic variant of invasive lobular carcinoma.

Keywords: breast cancer, lymphovascular invasion, D2-40 antibody, prognosis

Gitane

Hi mymountain,  This antibody is news to me, although I must say I don't know what antibody is used routinely either.  I do know that lobular BC usually gets special staining to look for micromets and itc's since these are more common in ILC.

Makes me a bit nervous to know that LVI is found in node negative patients, too.  If these cases are typical, it sounds like D2-40 may improve lymph node staging.