Clinicopathological features and prognosis analysis of breast invasive micropapillary carcinoma with different composition ratios_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

MIN Dan , LIU Pei , XU Shiyuan , YU Tong ,  WU Bin

1. Department of Breast Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;

Corresponding author：

WU Bin, Email: wwbb129@sina.com

Keywords：

breast carcinoma; invasive micropapillary carcinoma; clinicopathologic features; prognosis

DOI：

10.7507/1007-9424.202310083

Video：

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Objective To compare the clinicopathological characteristics of breast invasive micropapillary carcinoma (IMPC) with different composition ratios, and analyze the relationship between proportion of micropapillary carcinoma components and the prognosis of IMPC. Methods The related data of 121 patients with invasive ductal carcinoma (IDC) complicated with IMPC who were treated in the Department of Breast Surgery, Affiliated Hospital of Southwest Medical University from August 2016 to August 2020 were collected. With micropapillary carcinoma accounting for 50%, the patients were divided into IMPC <50% group and IMPC ≥50% group. The correlation between related clinicopathological features and prognosis of patients was analyzed. Results There were 85 patients in the IMPC <50% group and 36 patients in the IMPC ≥50% group. The analysis results showed that there was no significant differences between the two groups in menstrual status, histological grade, molecular typing, TNM stage, age, immunohistochemical expression, neoadjuvant therapy, nerve invasion, nipple invasion, and skin invasion (P>0.05). The rate of lymphatic vessel invasion (LVI) in the IMPC ≥50% group was 83.33% (30/36), which was significantly higher than 61.18% (52/85) in the IMPC <50% group, and the difference between the two groups was statistically significant (χ²=5.684, P=0.017). Kaplan-Meier survival curve was drawn, and the analysis results showed that the 3-year cumulative disease-free survival (DFS) of IMPC patients was correlated with the number of lymph node metastasis and LVI (P<0.05). And with the estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular typing, proportion of micropapillary carcinoma components and histological grade were unrelated (P>0.05). The results of multivariate Cox risk regression analysis showed that the number of lymph node metastases and LVI were independent prognostic factors affecting DFS in patients. Conclusions When the proportion of IMPC component is ≥50%, the LVI rate of tumor is higher than that of IMPC component <50%. The number of lymph node metastasis and LVI are independent prognostic factors affecting DFS in IMPC patients.

Citation： MIN Dan, LIU Pei, XU Shiyuan, YU Tong, WU Bin. Clinicopathological features and prognosis analysis of breast invasive micropapillary carcinoma with different composition ratios. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(3): 330-336. doi: 10.7507/1007-9424.202310083 Copy

1.	Wang R, Li N, Wang XJ, et al. Differences in the clinico-pathological characteristics of pure and mixed invasive micropapillary breast carcinomas from eastern China. Ann Transl Med, 2021, 9(5): 412.
2.	Fisher ER, Palekar AS, Redmond C, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (protocol no. 4). Ⅵ. Invasive papillary cancer. Am J Clin Pathol, 1980, 73(3): 313-322.
3.	Kim MJ, Gong G, Joo HJ, et al. Immunohistochemical and clinicopathologic characteristics of invasive ductal carcinoma of breast with micropapillary carcinoma component. Arch Pathol Lab Med, 2005, 129(10): 1277-1282.
4.	Kaya C, Uçak R, Bozkurt E, et al. The impact of micropapillary component ratio on the prognosis of patients with invasive micropapillary breast carcinoma. J Invest Surg, 2020, 33(1): 31-39.
5.	Eren Kupik G, Altundağ K. The clinicopathological characteristics of pure and mixed invasive micropapillary breast carcinomas: A single center experience. Balkan Med J, 2022, 39(4): 275-281.
6.	Guan X, Xu G, Shi A, et al. Comparison of clinicopathological characteristics and prognosis among patients with pure invasive ductal carcinoma, invasive ductal carcinoma coexisted with invasive micropapillary carcinoma, and invasive ductal carcinoma coexisted with ductal carcinoma in situ: A retrospective cohort study. Medicine (Baltimore), 2020, 99(50): e23487.
7.	Chen L, Fan Y, Lang RG, et al. Breast carcinoma with micropapillary features: clinicopathologic study and long-term follow-up of 100 cases. Int J Surg Pathol, 2008, 16(2): 155-163.
8.	Hao S, Zhao YY, Peng JJ, et al. Invasive micropapillary carcinoma of the breast had no difference in prognosis compared with invasive ductal carcinoma: a propensity-matched analysis. Sci Rep, 2019, 9(1): 286.
9.	Vingiani A, Maisonneuve P, Dell’orto P, et al. The clinical relevance of micropapillary carcinoma of the breast: a case-control study. Histopathology, 2013, 63(2): 217-224.
10.	Lewis GD, Xing Y, Haque W, et al. Prognosis of lymphotropic invasive micropapillary breast carcinoma analyzed by using data from the National Cancer Database. Cancer Commun (Lond), 2019, 39(1): 60.
11.	Ye F, Yu P, Li N, et al. Prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in breast: A meta-analysis of PSM studies. Breast, 2020, 51: 11-20.
12.	Yang YL, Liu BB, Zhang X, et al. Invasive micropapillary carcinoma of the breast: an update. Arch Pathol Lab Med, 2016, 140(8): 799-805.
13.	Teichgraeber DC, Guirguis MS, Whitman GJ. Breast cancer staging: updates in the AJCC cancer staging manual, 8th edition, and current challenges for radiologists, from the AJR special series on cancer staging. AJR Am J Roentgenol. 2021, 217(2): 278-290.
14.	中国抗癌协会乳腺癌专业委员会, 中华医学会肿瘤学分会乳腺肿瘤学组. 中国抗癌协会乳腺癌诊治指南与规范(2024年版). 中国癌症杂志, 2023, 33(12): 1092-1187.
15.	Allison KH, Hammond MEH, Dowsett M, et al. Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update. J Clin Oncol. 2020, 38(12): 1346-1366.
16.	《乳腺癌HER2检测指南(2019版)》编写组. 乳腺癌 HER2 检测指南(2019 版). 中华病理学杂志, 2019, 48(3): 169-175.
17.	中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)乳腺癌诊疗指南2020. 北京: 人民卫生出版社, 2020: 22-止页.
18.	汪成, 季福, 徐明, 等. 乳腺浸润性微乳头状癌的病理特征及其与转移的关系. 上海交通大学学报(医学版), 2011, 31(1): 72-75.
19.	Gokce H, Durak MG, Akin MM, et al. Invasive micropapillary carcinoma of the breast: a clinicopathologic study of 103 cases of an unusual and highly aggressive variant of breast carcinoma. Breast J, 2013, 19(4): 374-381.
20.	Gong Y, Sun X, Huo L, et al. Expression of cell adhesion molecules, CD44s and E-cadherin, and microvessel density in invasive micropapillary carcinoma of the breast. Histopathology, 2005, 46(1): 24-30.
21.	郭晓静, 陈凌, 郎荣刚, 等. 乳腺浸润性微乳头状癌的病理学特征与淋巴结转移的关系. 中华病理学杂志, 2006, 35(1): 8-12.
22.	Guo X, Chen L, Lang R, et al. Invasive micropapillary carcinoma of the breast: association of pathologic features with lymph node metastasis. Am J Clin Pathol, 2006, 126(5): 740-746.
23.	Shi Q, Shao K, Jia H, et al. Genomic alterations and evolution of cell clusters in metastatic invasive micropapillary carcinoma of the breast. Nat Commun, 2022, 13(1): 111.
24.	王仲照, 黄文亭, 王年昌, 等. 乳腺浸润性微乳头状癌临床病理特征及预后分析. 中华肿瘤防治杂志, 2017, 24(9): 615-620.
25.	Fernandez G, Prastawa M, Madduri AS, et al. Development and validation of an AI-enabled digital breast cancer assay to predict early-stage breast cancer recurrence within 6 years. Breast Cancer Res, 2022, 24(1): 93.
26.	Li W, Han Y, Wang C, et al. Precise pathologic diagnosis and individualized treatment improve the outcomes of invasive micropapillary carcinoma of the breast: a 12-year prospective clinical study. Mod Pathol, 2018, 31(6): 956-964.
27.	Li Y, Liu J, Xu Z, et al. Construction and validation of a nomogram for predicting the prognosis of patients with lymph node-positive invasive micropapillary carcinoma of the breast: based on SEER database and external validation cohort. Front Oncol, 2023, 13: 1231302.

1. Wang R, Li N, Wang XJ, et al. Differences in the clinico-pathological characteristics of pure and mixed invasive micropapillary breast carcinomas from eastern China. Ann Transl Med, 2021, 9(5): 412.
2. Fisher ER, Palekar AS, Redmond C, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (protocol no. 4). Ⅵ. Invasive papillary cancer. Am J Clin Pathol, 1980, 73(3): 313-322.
3. Kim MJ, Gong G, Joo HJ, et al. Immunohistochemical and clinicopathologic characteristics of invasive ductal carcinoma of breast with micropapillary carcinoma component. Arch Pathol Lab Med, 2005, 129(10): 1277-1282.
4. Kaya C, Uçak R, Bozkurt E, et al. The impact of micropapillary component ratio on the prognosis of patients with invasive micropapillary breast carcinoma. J Invest Surg, 2020, 33(1): 31-39.
5. Eren Kupik G, Altundağ K. The clinicopathological characteristics of pure and mixed invasive micropapillary breast carcinomas: A single center experience. Balkan Med J, 2022, 39(4): 275-281.
6. Guan X, Xu G, Shi A, et al. Comparison of clinicopathological characteristics and prognosis among patients with pure invasive ductal carcinoma, invasive ductal carcinoma coexisted with invasive micropapillary carcinoma, and invasive ductal carcinoma coexisted with ductal carcinoma in situ: A retrospective cohort study. Medicine (Baltimore), 2020, 99(50): e23487.
7. Chen L, Fan Y, Lang RG, et al. Breast carcinoma with micropapillary features: clinicopathologic study and long-term follow-up of 100 cases. Int J Surg Pathol, 2008, 16(2): 155-163.
8. Hao S, Zhao YY, Peng JJ, et al. Invasive micropapillary carcinoma of the breast had no difference in prognosis compared with invasive ductal carcinoma: a propensity-matched analysis. Sci Rep, 2019, 9(1): 286.
9. Vingiani A, Maisonneuve P, Dell’orto P, et al. The clinical relevance of micropapillary carcinoma of the breast: a case-control study. Histopathology, 2013, 63(2): 217-224.
10. Lewis GD, Xing Y, Haque W, et al. Prognosis of lymphotropic invasive micropapillary breast carcinoma analyzed by using data from the National Cancer Database. Cancer Commun (Lond), 2019, 39(1): 60.
11. Ye F, Yu P, Li N, et al. Prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in breast: A meta-analysis of PSM studies. Breast, 2020, 51: 11-20.
12. Yang YL, Liu BB, Zhang X, et al. Invasive micropapillary carcinoma of the breast: an update. Arch Pathol Lab Med, 2016, 140(8): 799-805.
13. Teichgraeber DC, Guirguis MS, Whitman GJ. Breast cancer staging: updates in the AJCC cancer staging manual, 8th edition, and current challenges for radiologists, from the AJR special series on cancer staging. AJR Am J Roentgenol. 2021, 217(2): 278-290.
14. 中国抗癌协会乳腺癌专业委员会, 中华医学会肿瘤学分会乳腺肿瘤学组. 中国抗癌协会乳腺癌诊治指南与规范(2024年版). 中国癌症杂志, 2023, 33(12): 1092-1187.
15. Allison KH, Hammond MEH, Dowsett M, et al. Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update. J Clin Oncol. 2020, 38(12): 1346-1366.
16. 《乳腺癌HER2检测指南(2019版)》编写组. 乳腺癌 HER2 检测指南(2019 版). 中华病理学杂志, 2019, 48(3): 169-175.
17. 中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)乳腺癌诊疗指南2020. 北京: 人民卫生出版社, 2020: 22-止页.
18. 汪成, 季福, 徐明, 等. 乳腺浸润性微乳头状癌的病理特征及其与转移的关系. 上海交通大学学报(医学版), 2011, 31(1): 72-75.
19. Gokce H, Durak MG, Akin MM, et al. Invasive micropapillary carcinoma of the breast: a clinicopathologic study of 103 cases of an unusual and highly aggressive variant of breast carcinoma. Breast J, 2013, 19(4): 374-381.
20. Gong Y, Sun X, Huo L, et al. Expression of cell adhesion molecules, CD44s and E-cadherin, and microvessel density in invasive micropapillary carcinoma of the breast. Histopathology, 2005, 46(1): 24-30.
21. 郭晓静, 陈凌, 郎荣刚, 等. 乳腺浸润性微乳头状癌的病理学特征与淋巴结转移的关系. 中华病理学杂志, 2006, 35(1): 8-12.
22. Guo X, Chen L, Lang R, et al. Invasive micropapillary carcinoma of the breast: association of pathologic features with lymph node metastasis. Am J Clin Pathol, 2006, 126(5): 740-746.
23. Shi Q, Shao K, Jia H, et al. Genomic alterations and evolution of cell clusters in metastatic invasive micropapillary carcinoma of the breast. Nat Commun, 2022, 13(1): 111.
24. 王仲照, 黄文亭, 王年昌, 等. 乳腺浸润性微乳头状癌临床病理特征及预后分析. 中华肿瘤防治杂志, 2017, 24(9): 615-620.
25. Fernandez G, Prastawa M, Madduri AS, et al. Development and validation of an AI-enabled digital breast cancer assay to predict early-stage breast cancer recurrence within 6 years. Breast Cancer Res, 2022, 24(1): 93.
26. Li W, Han Y, Wang C, et al. Precise pathologic diagnosis and individualized treatment improve the outcomes of invasive micropapillary carcinoma of the breast: a 12-year prospective clinical study. Mod Pathol, 2018, 31(6): 956-964.
27. Li Y, Liu J, Xu Z, et al. Construction and validation of a nomogram for predicting the prognosis of patients with lymph node-positive invasive micropapillary carcinoma of the breast: based on SEER database and external validation cohort. Front Oncol, 2023, 13: 1231302.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinicopathological features and prognosis analysis of breast invasive micropapillary carcinoma with different composition ratios

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