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Clinicopathologic study of invasive micropapillary carcinoma of the breast
Shen-Li Tang1,2, Ji-Qiao Yang1,2, Zheng-Gui Du1,2
1Department of Breast Surgery, West China Hospital/West China School of Medicine, Sichuan University, 610041, P.R. China.
Abstract:
Invasive micropapillary carcinoma (IMPC) is a rare subtype of breast carcinoma. It is presumed to be more aggressive than invasive ductal carcinoma (IDC), though it is uncertain whether the prognoses of IMPC and IDC differ. In this retrospective study, we compared the clinicopathologic characteristics and survival between 170 female patients with IMPC (pure or mixed with IDC) and 728 with pure IDC. The IMPC patients had higher clinical stages and histologic grades, higher incidences of lymphovascular invasion and axillary lymph node extracapsular extension, and a higher degree of lymph node involvement than IDC patients. Moreover, IMPC was associated with increases in estrogen receptor (ER) and progesterone receptor (PR) positivity and HER-2 overexpression. Although locoregional recurrence-free survival (LRRFS) and recurrence-free survival (RFS) were poorer in IMPC patients than IDC patients, overall survival and distant metastasis survival did not differ between the two groups. Multivariate analysis revealed that IMPC was an independent prognostic factor for LRRFS in breast cancer, and IMPC patients had poorer clinicopathologic characteristics and poorer RFS and LRRFS than IDC patients. We therefore suggest that to improve treatment decisions, patients with breast carcinoma be tested for the presence of this specific subtype.
Insights
Invasive micropapillary carcinoma (IMPC) shows aggressive features and poorer recurrence-free survival compared to invasive ductal carcinoma (IDC). Testing for IMPC may improve breast cancer treatment decisions.
Area of Science:
- Oncology
- Pathology
- Breast Cancer Research
Background:
- Invasive micropapillary carcinoma (IMPC) is a rare breast cancer subtype.
- Its aggressiveness and prognostic difference compared to invasive ductal carcinoma (IDC) remain uncertain.
Purpose of the Study:
- To compare clinicopathologic features and survival outcomes between IMPC and IDC patients.
- To determine if IMPC is an independent prognostic factor in breast cancer.
Main Methods:
- Retrospective analysis of 170 female patients with IMPC (pure or mixed) and 728 with pure IDC.
- Comparison of clinical stages, histologic grades, lymphovascular invasion, lymph node status, and receptor/HER2 status.
- Survival analysis including locoregional recurrence-free survival (LRRFS), recurrence-free survival (RFS), overall survival, and distant metastasis survival.
Main Results:
- IMPC patients presented with higher clinical stages, histologic grades, and lymph node involvement.
- Higher incidences of lymphovascular invasion, extracapsular extension, ER/PR positivity, and HER2 overexpression were observed in IMPC.
- IMPC was associated with poorer LRRFS and RFS but not overall or distant metastasis survival compared to IDC.
Conclusions:
- IMPC is an independent prognostic factor for LRRFS in breast cancer.
- IMPC patients exhibit poorer clinicopathologic characteristics and recurrence-free survival.
- Testing for IMPC presence is suggested to enhance breast cancer treatment decisions.