Invasive micropapillary carcinoma of the breast: Clinicopathological and immunohistochemical study

Abstract

Invasive micropapillary carcinoma (IMPCa) of the breast refers to a unique variant of invasive ductal carcinoma, but its biological behavior has not been elucidated well. We analyzed 16 IMPCa cases (10 pure type, six mixed type). The incidence of IMPCa was 1.0% of all primary breast carcinoma. High nuclear grade (75.0%), as well as poorly differentiated histological grade (81.3%), was frequently seen. Lymph node metastases were evident in 92.9% of the examined cases, and about half of them showed more than 10 positive nodes. Comparison between serially experienced invasive ductal carcinoma, not otherwise specified (IDC-NOS), revealed that both high nuclear grade and poor histological grade were significantly more frequent (P < 0001), there was a lower frequency of positive estrogen receptor/progesterone receptor (P < 0.05, P < 0.01), a higher frequency of HER-2 overexpression (P < 0.025), and more frequent lymph node metastases (P < 0.05) in IMPCa. The comparison between lymph node positive IDC-NOS did not show any statistically significant differences in frequency for positive p53, matrix metalloproteinase protein-2 (MMP-2), vascular endothelial growth factor (VEGF) or E-cadherin. However, IMPCa showed a significantly increased number of blood vessels counted by CD34 immunostains (P < 0.05). These results suggest that IMPCa is, at least, the same or more aggressive than lymph node positive cases of IDC-NOS. Hence, not only the high incidence of lymph node metastases but also distant, blood-borne metastases may be important.

Invasive micropapillary carcinoma of the mammary glands in a mare

“…Characteristics observed in this report such as low cell proliferation index, positivity for hormone receptors, and negativity for HER-2 are related to better prognosis in humans (Pinder et al 1995;Onitilo et al 2009). However, metastasis to all lymph nodes was observed, supporting the described lymphatic dissemination in humans (Luna-more´et al 1994;De la Cruz et al 2004), dogs (Cassali et al 2002), and cats (Seixas et al 2007).…”

Micropapillary carcinoma: pathogenesis, histological and clinical features

“…Bu boşlukların vasküler kökenli olmadığı immünohistokimyasal olarak endotelyal belirteçler (CD31 ve FaktörVIII) ile boyanmamaları ile kanıtlanmıştır (17). İMPK için tanımlayıcı bir özellik olan bu boşluklar fiksasyon artefaktıdır ve frozen kesitlerde bu boşluklar izlenmemektedir (18).…”

“…Mikropapiller karsinom komponentinin nükleer özellikleri genellikle eşlik eden duktal komponente benzer ve yüksek derecelidir (6)(7)(8)(9)(10)(11). Duktal karsinoma in situ (DKİS) %53-80 oranında görülmekte olup çoğunlukla mikropapiller, kribriform veya papiller tiptedir (1,7,8,18,20).…”

“…İMPK'un agresif davranışına uygun olarak, bu olguların yarısından fazlasında yüksek oranda p53 protein ekspresyonu görüldüğü bildirilmiştir (8)(9)(10). İMPK'un agresifliğinin başka bir kanıtı ise bir adezyon molekülü olan N-kadherin'in aşırı ekspresyonudur (26).…”

Cutaneous invasive micropapillary carcinoma of probable apocrine sweat gland origin in a cat

“…In a study based on data collected from 1,056 women with primary breast carcinoma, the incidence of all IMC variants was 11 (1.0%) and that of pure IMC was 6 (0.6%). 2 In a report based on 16 female cats with mammary IMCs, only 1 (6.3%) had a pure micropapillary pattern. 11 In an unrelated dog study, none of the 9 IMCs evaluated showed a pure micropapillary pattern.…”