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Copyright (c) 2025 Saman Rafeeq Abdullah
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The undersigned hereby assign all rights, included but not limited to copyright, for this manuscript to CMB Association upon its submission for consideration to publication on Cellular and Molecular Biology. The rights assigned include, but are not limited to, the sole and exclusive rights to license, sell, subsequently assign, derive, distribute, display and reproduce this manuscript, in whole or in part, in any format, electronic or otherwise, including those in existence at the time this agreement was signed. The authors hereby warrant that they have not granted or assigned, and shall not grant or assign, the aforementioned rights to any other person, firm, organization, or other entity. All rights are automatically restored to authors if this manuscript is not accepted for publication.The role of an immunohistochemical panel including CD45, CK5/6, and ER in classifying challenging breast lesions in Iraqi pathology
Corresponding Author(s) : Saman Rafeeq Abdullah
Cellular and Molecular Biology,
Vol. 71 No. 12: Issue 12
Abstract
Accurate diagnosis of breast lesions is often complicated by the morphological overlap between benign, pre-malignant, and malignant entities on hematoxylin and eosin (H&E) stained sections. This study evaluated the diagnostic utility of an immunohistochemical (IHC) panel, comprising Estrogen Receptor (ER), Cytokeratin 5/6 (CK5/6), and Leukocyte Common Antigen (CD45), in resolving these diagnostic ambiguities among Iraqi patients. The panel was designed to differentiate epithelial (ER, CK5/6) and lymphoid (CD45) lineages, enabling the distinction between benign, pre-malignant, and malignant processes. A retrospective cross-sectional analysis was performed on 120 challenging breast lesions where the initial H&E diagnosis was inconclusive. Statistical performance was assessed using sensitivity, specificity, and accuracy metrics, with significance determined at p < 0.05. The IHC panel resulted in the reclassification of 53 cases (44.2%), with the highest reclassification in ADH (72.0%). The combined panel demonstrated 91.1% sensitivity, 93.3% specificity, and 92.5% accuracy (p < 0.001) for differentiating benign from malignant lesions. ER and CK5/6 were decisive in the majority of reclassified cases. In conclusion, the three-marker IHC panel (ER, CK5/6, and CD45) provides a statistically significant improvement in diagnostic accuracy and reliability in challenging breast lesions, reducing diagnostic uncertainty and supporting optimal patient management.
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