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Objective: We aimed to investigate the clinicopathology and prognosis of invasive micropapillary carcinoma (IMPC) of the breast. Methods: This was a single-center retrospective study based on the clinicopathological and follow-up data of 246 patients with IMPC who were treated at the Tianjin Medical University Cancer Institute and Hospital between January 2011 and December 2015. The patients were divided into two groups: we included 143 patients with >50% IMPC in group A and the remaining 103 patients in group B. The cox proportional-hazard regression model, Log-rank test, and Kaplan-Meier method were used for analysis. Results: The 5-year disease-free survival (DFS; 76.5% vs. 83.6%, P=0.042) and overall survival (OS; 74.1% vs. 81.6%, P=0.029) of group A were lower than those of group B. The DFS (χ2=5.219, P=0.022) and OS (χ2=3.96, P=0.047) of patients who did not receive radiotherapy in group A were lower than those of patients who received radiotherapy. Multivariate Cox regression analysis showed that HER-2 expression (HR= 2.989, 95% CI 1.400-6.384, P=0.005), mammilla invasion (HR=2.388, 95% CI 1.263-4.518, P=0.007), and ≥4 lymph node metastasis (HR= 2.076, 95% CI 1.080-3.992, P=0.029) were independent risk factors for DFS. Mammilla invasion (HR=1.951, 95% CI 1.054-3.609, P= 0.033) was an independent risk factor for OS. The DFS (χ2=6.541, P=0.011) and OS (χ2=6.455, P=0.012) in patients with mammilla invasion who did not receive radiotherapy were significantly lower than those of patients who received radiotherapy. Conclusion: As a special type of breast cancer, mammilla invasion indicates a poor prognosis. The prognosis of patients with >50% IMPC was worse than that of patients with ≤50% IMPC. Postoperative adjuvant radiotherapy may provide survival benefit to patients with IMPC accounting for 50% or mammilla invasion.
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Objective: To investigate the prognosis of patients who receive neoadjuvant chemotherapy (NAC) for invasive micropapillary carcinoma (IMPC) of the breast using a propensity score matching (PSM) method and to analyze the effects of NAC. Methods: Clinical and pathological data of a total of 251 cases of IMPC of the breast were collected for this study, from January 2011 to March 2014 in Tianjin Medical University Cancer Institute and Hospital, of which the NAC group comprised 67 cases and the non-NAC group comprised 184 cases. Tumor sizes before and after NAC were compared in the NAC group. Prognostic differences were compared between the NAC group and non-NAC group before and after PSM balancing the baseline. Results: The mean value of the maximum dimensions significantly reduced from 5.0cm to 4.2cm in the NAC group after NAC (P=0.035), but there was no statistically significant difference in T stage changes (P=0.064). A total of 49 pairs of patients were matched after PSM, and differences in the baseline data of the paired group were not significant. Univariate survival analysis showed no significant difference in the recurrence-free survival (RFS) rate between the NAC group (77.6% vs. 89.2%) and non-NAC group (72.1% vs. 91.0%) before and after PSM (all P>0.05). The 5-year distant metastasis-free survival (DMFS) rates in the NAC group before and after PSM were 53.4% and 50.0%, respectively, which were both significantly lower than those in the non-NAC group 69.1%, 59.2% (all P<0.05), and multivariate survival analysis showed that undergoing NAC was an independent prognostic factor of DMFS after PSM. Conclusion: Breast IMPC is a special type of tumor that is not sensitive to chemotherapy. Although some tumors decrease after NAC, IMPC patients do not benefit from NAC in terms of RFS; NAC may even increase the risk of distant metastasis. Therefore, IMPC patients should undergo surgical treatment as soon as possible, and NAC is not recommended.
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Objective To investigate the clinical pathological characteristics and the prognosis of the invasive micropapillary carcinoma (IMPC) of breast cancer.Methods The clinical pathological characteristics of 47 IMPC patients treated in the Second Hospital of Jilin University from Jan.2010 to Dec.2016 were retrospectively analyzed.A long term survival has been followed.Results 47 IMPC patients were all female.The median age was 56(34-76) years old.The median diameter of the tumor was 1.9(0.8-7.0) cm.The rate of axillary lymph node metastasis was 66.7％ (30/44),the median number of axillary lymph node metastasis was 9.5 (1-55),and the metastasis number of 1 to 3 accounted for 43.3％ (13/30),the metastasis number of 4 to 9 accounted for 6.7％ (2/30),and the metastasis number more than 10 accounted for 50％ (15/30).The lymphatic invasion rate was 40.2％(39/97),and the skin and (or) the nipple invasion rate was 15.6％(7/45).The positive rate of ER,PR,HER2,E-Cadherin was 95.7％(44/46),91.3％(42/46),10.5％(4/38),100％(40/40),respectively.The tumor cell growth index marked by Ki-67 was 1％-80％,and 78.3％ patients' tumor cell growth index marked by Ki-67 were more than 20％.Conclusions IMPC is a relatively rare special type of breast cancer,which typically occurs at middle-aged and old female.The expression of ER,PR,E-Cadherin is high and the expression of HER2 is low.It has strong ability and high positive rate of lymph node metastasis,lymphatic invasion,and poor prognosis.
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Objective:To investigate the expression and significance ofβ1 integrin, Rac1, and RhoA in invasive micropapillary breast carcinoma (IMPC). Methods:Immunohistochemical staining was performed to detect the expression ofβ1 integrin, Rac1, and RhoA in 89 patients with IMPC and 90 patients with invasive ductal carcinoma-not otherwise specified (IDC-NOS) who were treated between January 2007 and December 2008 in Tianjin Medical University Cancer Institute and Hospital. The relationship among the three proteins and the expression ofβ1 integrin, Rac1, and RhoA with clinicopathological features were determined. Results:β1 integrin (78.7%) and Rac1 (76.4%) were highly expressed in patients with IMPC. This expression was significantly higher than that in patients with IDC-NOS (63.3%and 54.4%). Statistical difference was found between the two groups (P0.05). Conclusion:Thus,β1 integrin, Rac1, and RhoA were overexpressed and might play an important role in the high frequency of metastasis in patients with IMPC. These proteins could be considered as biomarkers for the prognosis and new targets for IMPC therapy.
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Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.
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Objective:To investigate the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma (IMPC) of the breast. Methods:Data of 65 IMPC cases obtained from the Fourth Hospital of Hebei Medical University between Janu-ary 2009 and December 2011 were retrospectively analyzed. The expression of epithelial membrane antigen (EMA) was evaluated us-ing immunohistochemistry (IHC) to detect the micropapillary component in the tumor. The patients were divided into 4 groups based on the percentage of micropapillary component:≤10%, 11%-30%, 31%-50%, and>50%. Expressions of estrogen receptor (ER), pro-gesterone receptor (PR), and HER-2 were analyzed by IHC. Kaplan-Meier method, Log rank test, and multivariate Cox proportional hazard model were used to determine the factors affecting post-treatment survival. Results:Of the 65 cases, 12 were simple IMPC, 46 were IMPC with invasive ductal carcinoma, and 7 were other invasive carcinoma cases. The≤10%, 11%-30%, 31%-50%, and>50%micropapillary component groups comprised 7.69%(5/65), 44.62%(29/65), 26.15%(17/65), and 21.54%(14/65) of the total cases, re-spectively. Statistically significant differences were found in the four groups (P<0.01). IHC results showed that the positive rates of ER, PR, and HER-2 in the IMPC tissues were 76.92%(50/65), 67.69%(44/65), and 24.62%(16/65), respectively. Statistical differences ex-isted among the groups (P<0.05). Kaplan-Meier method indicated that positive rate of lymph node metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 significantly affect survival time of IMPC cases (P<0.05). Conclusion:Positive rate of nodal metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 are correlated with the prognosis of IMPC.
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PURPOSE: We performed this study to investigate the characteristic imaging and clinicopathologic features of invasive micropapillary carcinoma of the breast. MATERIALS AND METHODS: Among the 47 women with surgically confirmed invasive micropapillary carcinoma between 2005 and 2009, 32 patients (mean age, 50 years; range, 37-69 years) had all preoperative mammography, ultrasound (US) and MR images. Two radiologists retrospectively assessed the imaging findings, clinical presentation and histological results of the patients. RESULTS: On mammography, 29 of 32 patients had suspicious findings. Among them, a mass (or focal asymmetry) with calcifications was the most common findings (15/32, 65%). The calcifications were noted in 20 patients (63%) and the shape of calcifications was frequently amorphous or punctate (n = 12, 60%). On US and MR imaging, all lesions had suspicious findings. The most common US findings were single (n = 20) or multiple (n = 10) irregular hypoechoic mass (es). The mass was frequently hypoechoic (n = 29, 97%). On MR imaging, the type of lesions was a mass or masses in 23 (72%), a mass combined with non-mass in six patients, and non-mass lesions in three patients. Histologically, axillary lymph nodes metastasis were very common (25/32, 78%). Asymptomatic clinical presentation was not usual (9/32, 28%). CONCLUSION: The imaging features of invasive micropapillary carcinomas strongly suggest malignancy. Microcalcifications on mammography, marked hypoechogenicity on US and an irregular mass, often combined with non-mass on MR are common. Axillary lymph node metastasis is commonly associated.
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Female , Humans , Breast , Lymph Nodes , Mammography , Neoplasm Metastasis , Retrospective Studies , Ultrasonography, MammaryABSTRACT
Objective To study the clinical characteristics,pathology,and treatment for papillary carcinoma of the breast.Methods The clinical data of 17 patients of papillary carcinoma of the breast admitted in the First Affiliated Hospital of Wen Zhou Medical College were retrospectively analyzed.Results Papillary carcinoma of the breast accounted for 0.64％ of all breast cancer cases hospitalized during last 10 years.All cases had palpable lumps in the breast.12 cases received modified radical mastectomy,2 cases received simple mastectomy,2 cases underwent breast conservation therapy,1 case underwent simple mastectomy plus sentinel lymph node biopsy.15 patients received postoperative chemotherapy,among those 5 cases also received radiotherapy.During a 32.5-month median follow-up ( 1 month to 8 years),one case with bone metastases died 2 years postoperatively and another one died of multimetastases 7 years later.Conclusions The prognosis of papillary carcinoma of the breast is closely related with its pathology type.For intraductal papillary carcinoma low-traumatic therapy is applicable,while in case of infiltrating papillary carcinoma or invasive micropapillary carcinoma ( IMPC ),more aggressive therapies like that adopted for infiltrating ductal carcinoma are recommended.
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Invasive micropapillary carcinoma (IMPC) of the breast is recently described rare variant of invasive ductal carcinoma. This variant has a distinctive histological features and aggressive biological behavior. We reviewed the cytologic features of eight cases of IMPC. The cytologic smears showed moderate to high cellularity and the tumor tissue was composed of atypical, angulated, cohesive clusters of neoplastic cells with a papillary to tubuloalveolar architecture, and a morular growth pattern without fibrovascular cores was seen on the histopathology. IMPC of the breast has distinctive cytologic features and it is important to make an early diagnosis via fine needle aspiration cytology due to this tumor's aggressive behavior.
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Biopsy, Fine-Needle , Breast , Carcinoma, Ductal , Early DiagnosisABSTRACT
Invasive micropapillary carcinoma (IMPCa) is a rare variant of invasive ductal carcinoma of the breast. This variant is associated with a set of peculiar cytological findings and aggressive biological behaviors. In most reported cases, IMPCa has involved massive axillary lymph node metastases at the time of diagnosis. We experienced four cases of cytological features of IMPCa, all of which were verified by histological examination. Fine needle aspiration cytology (FNAC) revealed malignant epithelial cells, which formed small, oval to angulated papillary clusters, which lacked central fibrovascular cores. The histological findings of the four cases revealed both pure and mixed forms of IMPCa, composed of cohesive malignant epithelial cells, surrounded by distinctive clear spaces and separated by thin fibrous septa. All patients evidenced axillary lymph node metastases at the time of diagnosis. It is important to identify the peculiar cytological findings which would differentiate IMPCa from other diseases.
Subject(s)
Humans , Biopsy, Fine-Needle , Breast , Carcinoma, Ductal , Diagnosis , Epithelial Cells , Lymph Nodes , Neoplasm MetastasisABSTRACT
Invasive micropapillary carcinoma is a recently defined unusual variant of invasive breast carcinoma characterized by the formation of micropapillae within clear spaces separated by delicate fibrocollagenous stroma. This study was designed to examine clinicopathologic features of invasive micropapillary carcinoma of the breast. Sixteen cases of invasive micropapillary carcinoma were retrieved from the files of the Department of Pathology, Yeungnam University College of Medicine. We evaluated their clinicopathologic findings including patients' age, tumor size, nuclear grade, vascular invasion, axillary lymph node status, presence of extensive intraductal carcinoma, estrogen and progesterone receptors, p53, c-erbB-2, MIB-1 labelling index and follow-up data and compared this results with those of 292 cases of invasive ductal carcinoma, not otherwise specified. The incidence of invasive micropapillary carcinoma was 4.2% of all invasive breast carcinoma, and the mean age of the patients was 46 years. Nine cases were pure form (over 75% of micropapillary growth pattern in the tumor) and seven cases were mixed form. The results of clinicopathologic findings, except vascular invasion and axillary lymph node status, of the 16 cases of invasive micropapillary carcinoma were not different from those of the 292 cases of invasive ductal carcinoma, not otherwise specified (p>0.05). However, the rate of vascular invasion and axillary lymph node metastasis was significantly higher in invasive micropapillary carcinoma (p <0.05). Of 16 cases, five cases had distant metastasis during follow-up period, and one patient died of cancer. Although the mechanism of higher vascular invasion and lymph node metastasis in micropapillary growth pattern could not be determined, we propose that invasive micropapillary carcinoma should be recognized as a separate entity with increased risks of vascular invasion and axillary lymph node metastsis.