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

Meng, Xiangdi; Ma, Hongyu; Yin, Hang; Yin, Huizi; Yu, Lili; Liu, Li; Li, Tingting; Wang, Siqi; Xu, Qingyong

doi:10.1016/j.clbc.2020.12.003

Cited by 20 publications

(19 citation statements)

References 24 publications

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“…Accordingly, many researchers recommended that patients with IMPC should receive radiotherapy (20,23). Meng et al (24) demonstrated that radiation therapy was significantly associated with improved LRR after mastectomy in IMPC. However, the clinical value of BCT for IMPC is still unclear.…”

Section: Discussionmentioning

confidence: 99%

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Survival Outcomes After Breast-Conserving Therapy Compared With Mastectomy for Patients With Early-Stage Invasive Micropapillary Carcinoma of the Breast: A SEER Population-Based Study

et al. 2021

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BackgroundInvasive micropapillary breast carcinoma (IMPC) is a relatively rare pathological type of invasive breast cancer. Little is currently known on the efficacy and safety of breast-conserving treatment (BCT, lumpectomy plus postsurgical radiation) compared with mastectomy in women diagnosed with early-stage IMPC. Accordingly, we sought to investigate the long-term prognostic differences between BCT and mastectomy in patients with T1-3N0-3M0 invasive micropapillary breast carcinoma using data from the Surveillance, Epidemiology, and End Results (SEER) database.Materials and MethodsWe retrospectively analyzed 1,203 female patients diagnosed with early-stage IMPC between 2004 and 2015 from the SEER database. The impact of different surgical approaches on patient prognosis was assessed by the Kaplan-Meier method and Cox proportional risk models.ResultsA total of 609 and 594 patients underwent mastectomy and BCT, respectively. Compared with patients who underwent a mastectomy, patients in the BCT group were older and had lower tumor diameters, lower rates of lymph nodes metastasis, and higher rates of ER receptor positivity and PR receptor positivity (p < 0.05). Kaplan-Meier plots showed that the overall survival (OS) and breast cancer-specific survival (BCSS) were higher in the BCT group than in the mastectomy group. In subgroup analysis, patients with T2 stage in the BCT group had better OS than the mastectomy group. Multivariate analysis showed no statistical difference in OS and BCSS for patients in the mastectomy group compared with the BCT group (hazard ratio (HR) = 0.727; 95% confidence interval (95% CI) 0.369–1.432, p = 0.357; HR = 0.762; 95% CI 0.302–1.923, p = 0.565; respectively). During the multivariate analysis and stratifying for the T stage, a better OS was found for patients with T2 stage in the BCT group than the mastectomy group (HR = 0.333, 95% CI: 0.149–0.741, p = 0.007). There was no significant difference in OS for patients with T1 and T3 stages between the BCT and mastectomy groups (p > 0.05).ConclusionIn women with early-stage IMPC, BCT was at least equivalent to mastectomy in terms of survival outcomes. When both procedures are feasible, BCT should be recommended as the standard surgical treatment, especially for patients with T2 disease.

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Section: Discussionmentioning

confidence: 99%

“…Meng et al. ( 24 ) demonstrated that radiation therapy was significantly associated with improved LRR after mastectomy in IMPC. However, the clinical value of BCT for IMPC is still unclear.…”

Section: Discussionmentioning

confidence: 99%

Survival Outcomes After Breast-Conserving Therapy Compared With Mastectomy for Patients With Early-Stage Invasive Micropapillary Carcinoma of the Breast: A SEER Population-Based Study

et al. 2021

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“…Micropapillary breast carcinoma is best known for its tendency for lymphovascular invasion and lymph node metastases. The prevalence of nodal invasion at presentation is remarkably elevated for IMPC, reaching rates of 75%, and even 95% in some case series [19][20][21]. Several studies have determined that the frequency of nodal involvement in IMPC, is significantly higher compared to non-specific type (NST) carcinoma, as well as the mean number of disease-positive lymph nodes excised in patients.…”

Section: Discussionmentioning

confidence: 99%

A rare case of invasive micropapillary carcinoma of the breast

Verras¹,

Mulita²,

Tchabashvili³

et al. 2022

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Invasive micropapillary carcinoma (IMPC) is a rare, distinct histological subtype of breast carcinoma. While micropapillary histological architecture is found in up to 2-8% of all breast cancers, pure micropapillary carcinoma is infrequent and comprises 0.9-2% of breast carcinomas. Invasive micropapillary carcinoma is emerging as an oncological and surgical challenge due to a plethora of characteristics that constitute this histological pattern -interestingly, both elusive and aggressive. We present the case of a woman presenting with IMPC, who was primarily treated with tumour and lymph node marking, followed by primary systemic therapy (PST), and consequent oncoplastic surgery with sentinel lymph node biopsy. Our case report outlines the importance of awareness of histological subtypes in breast cancer by focusing on a case report of IMPC. The breast surgeon must be aware of the lymphotropic behaviour of this subtype and the high prevalence of lymph node involvement in such patients, and therefore focus on rigorous axillary assessment. One must not forget that, despite having a more aggressive biological profile, IMPC has demonstrated no difference in survival when compared to other histological subtypes, and treatment should conform to international guidelines with an emphasis on nodal staging.

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“… 15 , 23 , 142 A recently published nomogram predicting the individual risk for locoregional recurrence, specific for micropapillary breast carcinoma, could be of use in risk-stratifying these patients. 154 …”

Section: Lymphovascular Invasion and Lymph Node Involvementmentioning

confidence: 99%

Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis

GI¹,

Tchabashvili²,

Mulita³

et al. 2022

BCTT

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Invasive micropapillary carcinoma (IMPC) of the breast is an infrequent type of breast cancer often discussed for its potency for lymphovascular invasion and difficulty in accurate imaging estimation. Micropapillary carcinomas are noted to be present as larger tumors, of higher histological grade and a notably higher percentage of disease-positive lymph nodes. Hormonal and HER-2 positivity in IMPC is also commoner when compared to other NST carcinomas. IMPC occurs either as a pure form or more often as a component of mixed Non-Specific Type (NST) carcinoma. The latest data suggest that despite having comparable survival rates to other histological subtypes of breast carcinoma, effective surgical treatment often requires extended surgical margins and vigilant preoperative axillary staging due to an increased incidence of lymph node invasion, and locoregional recurrence. Moreover, the presence of micropapillary in situ components within tumors also seems to alter tumor aggression and influence the nodal disease stage. In this review, we present an overview of the current literature of micropapillary carcinoma of the breast from biology to prognosis, focusing on biological differences and treatment.

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

Cited by 20 publications

References 24 publications

Survival Outcomes After Breast-Conserving Therapy Compared With Mastectomy for Patients With Early-Stage Invasive Micropapillary Carcinoma of the Breast: A SEER Population-Based Study

Survival Outcomes After Breast-Conserving Therapy Compared With Mastectomy for Patients With Early-Stage Invasive Micropapillary Carcinoma of the Breast: A SEER Population-Based Study

A rare case of invasive micropapillary carcinoma of the breast

Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis

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