Clinicopathologic features of invasive metaplastic and micropapillary breast carcinoma: comparison with invasive ductal carcinoma of breast

Atif Ali Hashmi,Mariam Nisar,Saher Aijaz,Amir Khan,Naveen Faridi,Maham Siddiqui,Muhammad Muzzammil Edhi,Saadia Mehmood Khan,Muhammad Irfan,Narisa Iftikhar,Raeesa Mahboob

doi:10.1186/s13104-018-3623-z

Abstract

ObjectivesThe aim of this study was to determine the frequency of metaplastic breast carcinoma and invasive micropapillary carcinoma in our population and also to compare the clinico-pathologic features of metaplastic breast carcinoma and invasive micropapillary carcinoma with invasive ductal carcinoma, not otherwise specified (IDC, NOS).Results86.9% of the cases were identified as ductal carcinoma, NOS, while 2.2% were metaplastic and 0.76% cases were micropapillary carcinoma. Metaplastic carcinomas were found to be of higher grade as compared to IDC, NOS as 81% of metaplastic carcinoma were grade III compared to 35% IDC, NOS. 79% of metaplastic carcinoma were ER negative and 86% were PR negative, respectively as compared to ductal carcinoma NOS, which were 40% ER negative and 54% were PR. Similarly, 86.7% micropapillary cancers were ER positive and 73.3% were PR positive. Moreover, 66.7% micropapillary carcinoma showed nodal metastasis and 77.8% showed lymphovascular invasion, which was significantly higher than that of IDC, NOS micropapillary and metaplastic carcinomas accounts for less than 2 and 1% of the breast cancer burden in our population and highly correlates with poor prognosis parameters therefore, require more intensive management in our population.

Highlights

Due to heterogeneous nature of the breast cancer, understanding of potentially aggressive cancers helps in designing tailored therapeutic interventions as it assists in comprehending the prognosis of the disease
Since these subtypes of breast cancers are less responsive to conventional hormonal and chemotherapeutic interventions, we aimed to evaluate the frequency of metaplastic breast carcinoma and invasive micropapillary carcinoma in our population with regard to clinico-pathologic features of invasive ductal carcinoma, not otherwise specified
Metaplastic carcinomas were found to be of higher grade as compared to ductal carcinoma NOS (81% of metaplastic carcinoma were grade III compared to 35% ductal carcinoma, NOS)

Summary

Introduction

Due to heterogeneous nature of the breast cancer, understanding of potentially aggressive cancers helps in designing tailored therapeutic interventions as it assists in comprehending the prognosis of the disease. Metaplastic breast carcinomas (MBC) and invasive micropapillary breast carcinomas (IMBC) are two aggressive phenotypic variants of breast cancers with a low prevalence rate amongst the general population. Epithelial to mesenchymal transition in these subtypes of breast carcinomas are proposed to be associated with the tendency of the tumor cells to acquire properties of stem cells [10]. Since these subtypes of breast cancers are less responsive to conventional hormonal and chemotherapeutic interventions, we aimed to evaluate the frequency of metaplastic breast carcinoma and invasive micropapillary carcinoma in our population with regard to clinico-pathologic features of invasive ductal carcinoma, not otherwise specified. Evaluating prognostic features of micropapillary and metaplastic breast cancer in this study will be helpful in individualizing treatment strategies in locoregional population

Objectives

Results

Conclusion