Characteristic Morphology of Invasive Micropapillary Carcinoma of the Breast: An Immunohistochemical Analysis

Yamaguchi, Rin; Tanaka, Maki; Kondo, Keiko; Yokoyama, Tetsuo; Kaneko, Yuko; Miki, Yoshio; Osuga, Yutaka; Nakashima, Osamu; Kage, Masayoshi; Yano, Hirohisa

doi:10.1093/jjco/hyq056

Cited by 33 publications

(27 citation statements)

References 20 publications

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“…In our study, the percentage of lymph node metastasis (51.3%), tumor larger than 2 cm (41.6%) and stage III disease (22.6%) were significantly higher than those of IDC, resulting in higher percentage of chemotherapy. But in previous studies, the incidence of lymph node involvement was as high as 60–90% , and Shi et al. reported 51.3% cases of IMPC presented with AJCC stage III .…”

Section: Discussionmentioning

confidence: 91%

Invasive micropapillary carcinoma of the breast has a better long‐term survival than invasive ductal carcinoma of the breast in spite of its aggressive clinical presentations: a comparison based on large population database and case–control analysis

Chen

Wang

et al. 2017

Cancer Medicine

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There are controversies in the comparison of overall survival between invasive micropapillary carcinoma of the breast (IMPC) and invasive ductal carcinoma (IDC). The objective of this study was to compare the long‐term survival outcome between non‐metastatic IMPC and IDC. The Surveillance, Epidemiology, and End Results database was searched to identify women with non‐metastatic IMPC and IDC diagnosed between 2001 and 2013. Comparisons of patient and tumor characteristics were performed using Pearson's chi‐square. The propensity score matching method was applied with each IMPC matched to one IDC. Breast cancer‐specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan–Meier product limit method and compared across groups using the log‐rank statistic. Multivariate analysis was performed through Cox models. IMPC was presented with aggressive clinical presentations such as larger tumor, more positive lymph nodes, and more advanced stage compared with IDC. A higher rate of estrogen receptor (ER)/progesterone receptor (PR) positivity was also observed in IMPC. With a median follow‐up of 64 months, IMPC had a better BCSS (P = 0.031) and OS (P = 0.012) compared with IDC. In a case–control analysis IMPC was still an independent favorable prognostic factor for BCSS (HR = 0.410, P < 0.001, 95% CI: 0.293–0.572) and OS (HR = 0.497, P < 0.001, 95% CI: 0.387–0.637). In subgroup analysis, IMPC always showed a better survival outcome compared with IDC except in AJCC stage I and histologic grade I disease. IMPC has a better long‐term survival outcome compared with IDC in spite of its highly aggressive clinical presentation.

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Section: Discussionmentioning

confidence: 91%

Invasive micropapillary carcinoma of the breast has a better long‐term survival than invasive ductal carcinoma of the breast in spite of its aggressive clinical presentations: a comparison based on large population database and case–control analysis

Chen

Wang

et al. 2017

Cancer Medicine

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“…IMPC is a rare histologic type that appears to be more aggressive compared to other breast cancers [13], [14] due to its increased probability of lymphovascular invasion and LN metastasis. IMPC typically demonstrates a LN metastasis rate of 46–95% [15], [16], [17], [18] compared with 34% for IDC. Therefore, given IMPC’s highly lymphotropic nature at initial presentation, IMPC has an unfavorable prognosis compared to IDC and therefore merits aggressive treatment.…”

Section: Discussionmentioning

confidence: 99%

Similar Prognoses for Invasive Micropapillary Breast Carcinoma and Pure Invasive Ductal Carcinoma: A Retrospectively Matched Cohort Study in China

Liu

Huang

et al. 2014

PLoS ONE

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PurposeInvasive micropapillary breast carcinoma (IMPC) is a rare pathological finding. Few studies have compared IMPC with invasive ductal breast carcinoma (IDC) according to matched nodal status and age. To better illustrate the difference between IMPC and IDC prognoses, we conducted this cohort study.Methods51 mixed or pure IMPC patients and 102 pure IDC patients were matched for nodal status and age. Clinical and biological features as well as disease-free survival (DFS) were compared between groups.ResultsMore than one-half of IMPC consisted of mostly or exclusively IMPC component (meaning greater than 75%) and these tumors significantly correlated with a higher histologic grade (P = 0.016) and LVI positivity (P = 0.036) compared with mixed IMPC. IMPC displayed a significantly higher rate of estrogen receptor (ER) positivity and lymphovascular invasion (LVI) compared to matched IDC. Women diagnosed with IMPC had a slight, but not significant, reduced frequency for recurrence and metastasis compared to women with IDC (15.7% vs. 21.6%, P = 0.518). In the subgroup analysis, IMPC patients demonstrated significantly reduced survival (P = 0.018) compared to IDC patients in the T1N2–3 subpopulation, whereas IDC patients demonstrated significantly increased recurrence and metastasis (P = 0.024) compared to IMPC patients in the T2N2–3 subgroup. No difference was observed in patients with 3 or less positive lymph nodes (LNs).ConclusionAlthough no difference in DFS was observed between IMPC and LN-matched IDC patients, IMPC patients demonstrated a significantly poorer outcome compared to IDC patients with smaller tumors and 4 or more positive LNs. The opposite results were observed in larger tumors and patients with 4 or more positive LNs. Therefore, we might advise more proactive treatment for IMPC patients with a smaller tumor size and extensive LN involvement. Furthermore, correlative IMPC studies should focus on this subset of patients to elucidate the genetic and/or biologic differences that contribute to metastatic potential.

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“…p63 expression in the cytoplasm has been identifi ed in secretory carcinomas, 28 pregnancy-associated carcinomas, 29 and invasive micropapillary carcinomas of the breast, 30 as well as in lung cancer 31 and prostatic cancer. 32 The cytoplasmic staining of p63 (a transcription factor involved in transactivation, apoptosis, and proliferation that usually stains the nucleus) may suggest an altered and potentially oncogenic function.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical study of metaplastic carcinoma and central acellular carcinoma of the breast: central acellular carcinoma is related to metaplastic carcinoma

et al. 2012

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Metaplastic breast cancers (MBCs) [spindle cell carcinoma (SpCC), squamous cell carcinoma (SCC), and matrix-producing carcinoma (MPC)] and invasive carcinomas with central acellular zones (CACs) were analyzed with respect to biological potential by immunohistochemical analyses. Specimens from 40 patients [20 with MBCs (7 with SCC, 6 with SpCC, 5 with MPC, and 2 with mixed type)] and 20 with CACs were analyzed using antibodies to cytokeratin (CK) 8, 5/6, 14, AE1/AE3, 34αE12, involucrin, c-kit, vimentin (VIM), alpha-smooth muscle actin, p63, epidermal growth factor receptor, epithelial cell adhesion molecule, and estrogen receptor (ER)/progesterone receptor (PR)/HER2. Expression of CK5/6, 34βE12, VIM, nuclear p63, and cytoplasmic p63 was significantly higher with MBCs than CACs (38%/13%, 70%/43%, 85%/33%, 68%/40%, and 48%/18%, respectively). Other markers were expressed at various levels in these tumors, but the difference between them was not significant. Eighteen MBC and 8 CAC cases were triple (ER/PR/HER2) negative; 17 MBCs and 7 CACs were basal-like tumors. Several differences were seen in MBCs and CACs, but they were heterogeneous, differentiating multipotentially into mesenchymal, myoepithelial, basal-like phenotypes with "stem cell-like" features. Thus, CACs are related to MBCs by immunohistochemical analyses as well as according to morphological findings.

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Characteristic Morphology of Invasive Micropapillary Carcinoma of the Breast: An Immunohistochemical Analysis

Cited by 33 publications

References 20 publications

Invasive micropapillary carcinoma of the breast has a better long‐term survival than invasive ductal carcinoma of the breast in spite of its aggressive clinical presentations: a comparison based on large population database and case–control analysis

Invasive micropapillary carcinoma of the breast has a better long‐term survival than invasive ductal carcinoma of the breast in spite of its aggressive clinical presentations: a comparison based on large population database and case–control analysis

Similar Prognoses for Invasive Micropapillary Breast Carcinoma and Pure Invasive Ductal Carcinoma: A Retrospectively Matched Cohort Study in China

Immunohistochemical study of metaplastic carcinoma and central acellular carcinoma of the breast: central acellular carcinoma is related to metaplastic carcinoma

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