Comparison of invasive micropapillary and invasive ductal carcinoma of the breast: a matched cohort study

Yoon, Ga Young; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung

doi:10.1177/0284185119834689

Cited by 20 publications

(24 citation statements)

References 26 publications

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“…However, we observed no effects on OS. This is consistent with the previous results of Chen et a [3,4] l. Moreover, research from Yoon GY et al was in agreement that the IMPC group showed a worse total recurrence-free survival(RFS) but found no signi cant difference in OS as well [20] . In their research, the IMPC group showed worse total RFS (hazard ratio [HR]=1.63, P=0.016), local RFS (HR=2.86, P=0.042), and distant RFS (HR=1.85 P=0.018), but there was no signi cant difference in OS(HR=1.30, P=0.335).…”

Section: Discussionsupporting

confidence: 92%

Long-term Survival Outcomes of Invasive Micropapillary Carcinoma of the Breast: A Population-based Study

Zhang¹,

Lin²,

Su³

et al. 2020

Preprint

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Background: Whether or not invasive micropapillary carcinoma(IMPC) histology is an independent prognostic factor for breast cancer remains controversial. Moreover, the relationship between different molecular subtypes and survival outcomes of IMPC and invasive ductal carcinoma (IDC) is still unknown.Methods: Using the SEER database to identify breast cancer patients, we retrospectively analyzed 959 IMPC and 174591 IDC cases diagnosed between 2010-2016 with non-metastatic diseases that underwent surgery. Specifically, we compared long-term outcomes of breast cancer-specific survival (BCSS) and overall survival (OS).Results: Relative to IDC patients, IMPC patients were younger at diagnosis and had more moderate and poorly differentiated tumors (93.2% vs. 78.5%), more T3 and T4 tumors (11.0% vs. 6.9%), a higher percentage of nodal involvement (48.9% vs. 30.9%) and AJCC stage III patients (11.9% vs. 6.9%), and presented a higher proportion of HR positivity (91.2% vs. 82.3%) and HER2 positivity (22.3% vs. 16.9%). IMPC had a better BCSS (P=0.039) but showed no significant difference in OS (P=0.095) compared with IDC. In multivariate Cox analysis, IMPC histologic type was an independent favorable prognostic factor for both BCSS (HR=0.509, P=0.002, 95%CI: 0.335-0.775) and OS (HR=0.637, P=0.003, 95%CI: 0.475-0.854). After the case-control matched analysis using the propensity score matching method, IMPC still had a better BCSS (P=0.001); however, we observed no significant difference in OS (P =0.385). While different molecular subtypes have different impacts on survival outcomes, no significant differences were observed in BCSS and OS between IMPC and IDC in relation to Luminal B, HER2-enriched, and Triple-negative subtypes. However, in relation to the Luminal A subtype, IMPC had better BCSS (HR= 0.399, P=0.001, 95%CI: 0.226−0.703) and OS (HR=0.508, P=0.001, 95%CI: 0.345−0.746). In the case-control cohort, IMPC still had a better BCSS (HR= 0.423, P=0.005, 95%CI: 0.233−0.770), but no significantly difference was observed in OS (HR=0.767, P=0.22, 95%CI: 0.502−1.172) in Luminal A subtype.Conclusion: Relative to IDC, IMPC presents better long-term survival outcomes, and the survival benefits are confined to the Luminal A subtype.

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Section: Discussionsupporting

confidence: 92%

Long-term Survival Outcomes of Invasive Micropapillary Carcinoma of the Breast: A Population-based Study

Zhang¹,

Lin²,

Su³

et al. 2020

Preprint

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“…A series of studies showed that the recurrence rate of patients with breast IMPC is higher than that of patients with IDC: Chen 95.4% to LRRFS, p=0.003, respectively). 1,5,8,9,14 Therefore, many researchers suggested mastectomy with axillary lymph node dissection as far as possible for greater margins and lower recurrence rates. 5,6,8 However, some studies found that it didn't improve prognosis.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…Invasive micropapillary carcinoma (IMPC) is a relatively rare but highly aggressive histological subtype that accounts for 0.9% to 8.4% of breast cancer cases, [1][2][3][4][5][6][7][8][9][10] which is often accompanied by extensive lymph node metastasis (LNM), lymphovascular invasion (LVI), high histologic grade, lymph node extracapsular extension, etc. 1,5,[7][8][9][10][11][12][13][14] Although these factors related to the highly local aggressive biological behavior of IMPC have been reported, it remained inconclusive whether this malignant behavior could translate into unfavorable prognosis, 7,15,16 even though that relationship has been widely accepted. Hence, it is necessary to identify the prognostic factors and then estimate the risk of recurrence for breast IMPC at present.…”

Section: Introductionmentioning

confidence: 99%

Nomogram Predicting the Risk of Locoregional Recurrence After Mastectomy for Invasive Micropapillary Carcinoma of the Breast

Meng

Yin

et al. 2021

Clinical Breast Cancer

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“…Forty one studies were excluded for not comparing with IDC or not using PSM method. Finally, eight publications were eligible for inclusion in this meta-analysis [ 11 , 15 , 18 , 24 , [26] , [27] , [28] , [29] ]. The PRISMA flow diagram is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in breast: A meta-analysis of PSM studies

Ye¹,

Yu²,

Li³

et al. 2020

The Breast

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Background Invasive micropapillary carcinoma (IMPC) is a rare histological subtype of breast cancer. The outcome of IMPC remains controversial; we conducted a meta-analysis of propensity score matching (PSM) studies to evaluate the prognostic difference between IMPC and invasive ductal carcinoma (IDC). Methods We searched PubMed, EMBASE and the Cochrane library for PSM studies comparing survival data between IMPC and IDC. The summarized odds ratios (ORs) and 95% confidence interval (95% CI) are calculated by STATA software utilizing fixed-effect or random-effect models, depending on the heterogeneity of the eligible studies. Results Eight PSM studies including 2102 IMPC patients are included in the meta-analysis. Compared with IDC, IMPC has a similar overall survival (OS) (estimated OR = 0.87, 95% CI: 0.61–1.25), but a shorter relapse free survival (RFS) (estimated OR = 1.31, 95% CI: 1.06–1.61); the shorter RFS might owe to the significantly higher loco-regional recurrence rate of IMPC (estimated OR = 3.60, 95% CI: 1.99–6.52). Funnel plots and Egger’s tests are used to evaluate publication bias and the p value for OS and RFS are 0.036 and 0.564 respectively. Conclusions Our results demonstrate that compared with IDC, IMPC exhibits a similar, even favorite OS, but a shorter RFS; and the shorter RFS might owe to the significantly higher loco-regional recurrence rate of IMPC. These results could contribute to the individualized therapy and follow-up strategies for IMPC patients.

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Comparison of invasive micropapillary and invasive ductal carcinoma of the breast: a matched cohort study

Cited by 20 publications

References 26 publications

Long-term Survival Outcomes of Invasive Micropapillary Carcinoma of the Breast: A Population-based Study

Long-term Survival Outcomes of Invasive Micropapillary Carcinoma of the Breast: A Population-based Study

Nomogram Predicting the Risk of Locoregional Recurrence After Mastectomy for Invasive Micropapillary Carcinoma of the Breast

Prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in breast: A meta-analysis of PSM studies

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