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Clinicopathological Features and Prognosis of Invasive Micropapillary Carcinoma Compared to Invasive Ductal
Fugen Vardar Aker1, Erhan Ekren1, Meryem Dogan1
1Department of Pathology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Objective:
To evaluate whether there are differences in invasive micropapillary carcinoma (IMPC) and invasive ductal carcinoma-NOS (IDC-NOS) according to the clinicopathological features and prognosis including molecular subtypes.
Study Design:
Descriptive study.
Place And Duration Of Study:
Department of Pathology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey, from 2003 to 2016.
Methodology:
Operated breast cancer cases (58 IMPC + 326 IDC-NOS), with long-term follow-up findings (cases followed up until 2020), were reviewed. The cases, whose other component was only IDC-NOS, were included in the mixed IMPC group. The clinical features, including clinical presentation, treatments, and follow-up information were obtained from the patient clinical database. The IMPC cases included in the study were re-examined, and micropapillary tumour components were confirmed based on the criteria set by the World Health Organisation (WHO). The clinicopathological findings, recurrence, and survival data of both groups were compared. In addition, IDC-NOS was divided into the molecular subgroups and compared with IMPC cases in terms of 5-year overall survival (OS).
Results:
There was no significant difference between the two groups for the distribution of molecular subtypes. There was a statistically significant difference among the nuclear grade, tumour size, nodal status, lymphovascular, and perineural invasion. In the first 5-year period, the OS rate for IDC-NOS and IMPC was 90.8% and 86.2% (p<0.05). The 5-year OS rate of luminal A, luminal B, HER2, triple negative (TN), and IMPC patients was 97.6%, 91.3%, 90%, 70%, and 86.2%, respectively (p<0.05). The OS rate in patients with TN and IMPC was similar which was found significantly lower than the other groups (luminal A, luminal B, and HER2). The median OS was 51.3 months and 53.9 months for the patients with TN and IMPC, respectively (p<0.001). This difference disappeared in the 10th and 15th years of follow-up.
Conclusion:
The majority of the deaths in IMPC occurred within the first 5 years. The 5-year OS rates were similar in the TN and IMPC patients. The survival pattern of IMPC is parallel with TN, Therefore, clinical, therapeutic, and prognostic evaluation in IMPC can be done like TN.
Key Words:
Invasive ductal carcinoma, Invasive micropapillary carcinoma, Survival.
Insights
Invasive micropapillary carcinoma (IMPC) and triple-negative breast cancer share similar survival rates, particularly within the first five years. This suggests IMPC can be clinically evaluated similarly to triple-negative breast cancer.
Area of Science:
- Oncology
- Pathology
- Breast Cancer Research
Background:
- Invasive ductal carcinoma (IDC-NOS) and invasive micropapillary carcinoma (IMPC) are distinct breast cancer subtypes.
- Understanding their clinicopathological differences and prognostic outcomes is crucial for effective treatment strategies.
Purpose of the Study:
- To compare invasive micropapillary carcinoma (IMPC) with invasive ductal carcinoma-NOS (IDC-NOS) based on clinicopathological features and survival.
- To investigate the molecular subtypes and their impact on prognosis for both IMPC and IDC-NOS.
Main Methods:
- A descriptive study reviewed 58 IMPC and 326 IDC-NOS cases diagnosed between 2003 and 2016.
- Clinicopathological data, treatments, and long-term follow-up (until 2020) were analyzed.
- IMPC cases were re-examined using WHO criteria, and IDC-NOS was classified into molecular subgroups for survival comparison.
Main Results:
- No significant difference in molecular subtype distribution was observed between IMPC and IDC-NOS.
- Significant differences were found in nuclear grade, tumor size, nodal status, and lymphovascular/perineural invasion.
- Five-year overall survival (OS) rates were 86.2% for IMPC and 90.8% for IDC-NOS (p<0.05).
- IMPC and triple-negative (TN) breast cancer showed similar, significantly lower 5-year OS rates (86.2% and 70%, respectively) compared to Luminal A, Luminal B, and HER2 subtypes.
Conclusions:
- The majority of deaths in IMPC occur within the first five years post-diagnosis.
- The 5-year OS rates for IMPC and TN breast cancer are comparable.
- The similar survival patterns suggest IMPC can be evaluated clinically and prognostically akin to TN breast cancer.
