Clinicopathological and ultrasonographic characteristics of breast infiltrative cribriform carcinoma

Abstract

Objective To explore the clinicopathological and ultrasonographic characteristics of breast invasive cribriform carcinoma (ICC). Methods We retrospectively analyzed the clinical data of 8 patients with breast ICC in Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2013 to September 2018. Results All eight cases were female, with median age of 46 years (range: 26-81 years). There were four patients with simple ICC and four patients with mixed type. Six patients had no lymph node metastasis and the other two patients had the metastasis of two lymph nodes. Seven cases were ER-positive and PR-positive; one case was ER-positive and PR-negative. The cell proliferation index Ki67 was ≤30% in all eight cases. Preoperative ultrasound diagnosis revealed three cases of BI-RADS 4A, one case of BI-RADS 4B, and four cases of BI-RADS 4C and 5. Ultrasonic findings were as follow: aspect ratio >1 and irregular morphology in all lesions; clear border in six cases and unclear border in two cases; smooth edge in two cases, burred, lobular or angled edge in six cases; hypoechoic area in eight cases, including posterior echo enhancement in four cases, no change in two cases and sound attenuation in two cases; fine calcification in three cases; punctiform and rod-shape blood flow signals in six cases, one or two perforating vessels in two cases, median arterial resistance index of 0.75. One patient underwent breast conservative surgery and ipsilateral axillary lymph node dissection, one patient underwent left mastectomy and sentinel lymph node biopsy, and the other 6 patients underwent modified radical mastectomy. All patients received adjuvant chemotherapy and endocrine therapy after surgery. All patients were followed up for 3 to 48 months (median 10 months). During the follow-up, no recurrence, metastasis and death were observed in 8 cases. Conclusions Breast ICC is a malignant tumor with good prognosis. The patients with simple ICC usually present the ultrasonographic characteristics of benign nodules. The breast clinicians and ultrasound doctors should improve their awareness of this disease in order to reduce the rate of misdiagnosis and improve preoperative diagnosis rate. Key words: Breast neoplasms; Ultrasonography; Invasive cribriform carcinoma