Invasive Micropapillary Carcinoma Component Research Articles

The Clinicopathological Characteristics of Pure and Mixed Invasive Micropapillary Breast Carcinomas: A Single Center Experience.

Background:Invasive micropapillary carcinoma (IMPC) is a rare tumor of the breast. IMPC can be classified as a pure or mixed type based on the extent of micropapillary differentiation.Aims:To evaluate the prognostic importance of the IMPC component in breast cancer through retrospective comparison of the clinicopathological characteristics and clinical outcomes of pure and mixed IMPC patients.Study Design:The data of 147 (2.2%) patients with IMPC among 6648 patients histopathologically diagnosed with invasive breast cancer between January 2000-2022 were retrospectively reviewed. The patients were assigned to two groups: pure IMPC and mixed IMPC.Methods:The clinicopathological features such as age at diagnosis, histological type, grade, size, and components of mixed carcinoma, the numbers of metastatic lymph nodes, presence of lymph vascular invasion, hormone receptor, and the Her-2 status of the tumor, T, N, M stages, and the survival rates were reviewed. The clinicopathologic features, patterns of failures, and survival rates were coded and compared between pure and mixed IMPC patients.Results:A total of 45 patients (30.6%) had pure and 102 patients (69.4%) had mixed IMPC. The median follow-up time was 46 months (3-178). The progesterone receptor positivity rate was significantly lower in the pure group than in the mixed group (66.7% vs. 83.3%, p: 0.024). In the pure and mixed groups, respectively, the 5-year overall survival was 90% and 91% (p: 0.839); progression-free survival was 70% and 77% (p: 0.537); locoregional recurrence-free survival was 86% and 95% (p: 0.043); 5-year distant metastasis-free survival was 88% and 83% (p: 0.066), and the locoregional recurrence rate was 10.3% and 2% (p: 0.052).Conclusion:Compared to the mixed IMPC, pure IMPC appears to have a more aggressive behavior with lower locoregional recurrence-free survival and more locoregional recurrences. This may be due to the low progesterone receptor positivity rate.

A Case of Early Colorectal Cancer with Invasive Micropapillary Carcinoma Component with Peritoneal Dissemination Recurrence

A Case of Early Colorectal Cancer with Invasive Micropapillary Carcinoma Component with Peritoneal Dissemination Recurrence

Clinicopathological characteristics of pancreatic ductal adenocarcinoma with invasive micropapillary carcinoma component with emphasis on the usefulness of PKCζ immunostaining for detection of reverse polarity.

Invasive micropapillary carcinoma (IMPC) is a rare distinct histopathological subtype, characterized by the presence of carcinoma cells displaying reverse polarity. Only limited clinicopathological information is available regarding pancreatic IMPC. The aim of the present study was to clarify the clinicopathological features of pancreatic IMPC and the usefulness of protein kinase C (PKC)ζ immunostaining for the detection of reverse polarity. We reviewed 242 consecutive surgically resected specimens of pancreatic ductal adenocarcinoma and selected samples with an IMPC component. Clinicopathological characteristics were compared between the IMPC and non-IMPC groups. Immunohistochemical staining for PKCζ was performed using an autostainer. In total, 14 cases had an IMPC component (5.8%). The extent of IMPC component ranged from 5 to 20%. There were no significant differences in tumor location, T category, lymph node metastatic status, preoperative carbohydrate antigen 19-9 level, resection status and overall survival between the IMPC and non-IMPC groups. Immunostaining for PKCζ clearly showed reverse polarity of the neoplastic cells of IMPC. Although previous reports have shown that the presence of an IMPC component (>20% of the tumor) indicated poor prognosis, the present study demonstrated that presence of IMPC <20% did not suggest a worse prognosis.

Intense basolateral membrane staining indicates HER2 positivity in invasive micropapillary breast carcinoma.

Invasive micropapillary carcinoma is characterized by the inside-out growth of tumor clusters and displays incomplete membrane immunostaining of HER2. According to the 2018 American Society of Clinical Oncology and the College of American Pathologists (ASCO/CAP) HER2-testing recommendation, moderate to intense but incomplete staining could be scored as immunohistochemical 2+. Furthermore, the criteria of immunohistochemical 3+ for this staining pattern are not mentioned. One hundred and forty-seven cases of invasive micropapillary carcinoma with moderate-to-intense HER2 immunostaining were enrolled. Invasive micropapillary carcinoma components of all cases were scored as immunohistochemical 2+ based on the 2018 ASCO/CAP recommendation. The invasive micropapillary carcinoma component varied from 10% to 100% (mean, 80%). Invasive micropapillary carcinoma components of all 147 tumors exhibited reversed polarity and incomplete basolateral HER2 membrane staining. One hundred and seventeen of the tumors (80%, 117/147) had moderate staining, and 38 (32%, 38/117) showed HER2 gene amplification by fluorescence in-situ hybridization. HER2 gene was amplified in all the remaining 30 tumors (20%, 30/147) that exhibited intense basolateral membrane staining. Besides, average HER2 signals per cell and ratio of HER2/CEP17 were significantly higher in the intense-staining tumors compared with the moderate-staining tumors (p < 0.0001). Follow-up data were available for 140 patients. None of the patients were died. The follow-up time ranged from 1 month to 99 months (median, 57 months). Thirteen (9%, 13/140) patients exhibited disease progression (recurrence or metastasis). HER2 gene amplification was correlated inversely with estrogen receptor (p = 0.000) and progesterone receptor (p = 0.000) expression, and positively with histological grade (p = 0.003) and disease progression (p = 0.000). Invasive micropapillary carcinoma with intense clear linear basolateral membrane immunostaining indicates HER2 positivity, even if the staining is incomplete. They should be classified as immunohistochemical 3+ rather than immunohistochemical 2+, which would avoid further fluorescence in-situ hybridization-testing procedure and greatly save the related time, labor, and financial costs. Ultimately, ensure all patients with HER2 gene amplification obtain effective targeted therapy in time.

Three Cases of Gastric Intramucosal Adenocarcinoma with Invasive Micropapillary Carcinoma Component

Three Cases of Gastric Intramucosal Adenocarcinoma with Invasive Micropapillary Carcinoma Component

Invasive micropapillary carcinoma component is an independent prognosticator of poorer survival in Stage III colorectal cancer patients.

Invasive micropapillary carcinoma (IMPC) is an aggressive variant of adenocarcinoma found in several organs. Recent studies showed that IMPC in colorectal cancer leads to poorer prognosis than conventional colorectal cancer; however, the influence of IMPC on outcomes remains unclear. The present study aimed to identify the clinicopathological characteristics of colorectal cancers with IMPCs, and to evaluate the prognostic significance of IMPCs per se. We retrospectively analyzed data from 837 patients with colorectal cancer who underwent surgical treatment. We compared the clinicopathological characteristics and survival outcomes of colorectal cancer patients with IMPCs to those without. Among 837 patients, 130 (16%) had an IMPC component, including 0 (0%) of 18, 9 (4.2%) of 215, 34 (13%) of 254, 59 (24%) of 249 and 28 (27%) of 101 patients with TNM Stages 0, I, II, III and IV, respectively. The 3-year disease-free survival (DFS) rates were significantly worse for Stage III patients with IMPC than for those without (55.3% vs. 78.7% respectively, P < 0.001), but not in patients with other stages. Multivariate analyses of patients with Stage III colorectal cancer found IMPC to be associated with significantly worse DFS (P = 0.026), as were high CEA levels, tumor budding and TNM staging. IMPC was only significantly associated with tumor invasion (P = 0.045) and venous invasion (P = 0.045) in Stage III tumors. Identifying IMPC components in Stage III colorectal cancer is crucial, as their presence is significantly associated with poorer survival.

Tu1822 Clinicopathological Characterization of Colorectal Cancer With Invasive Micropapillary Carcinoma Component

Tu1822 Clinicopathological Characterization of Colorectal Cancer With Invasive Micropapillary Carcinoma Component

乳腺浸润性微乳头状癌与浸润性癌(非特殊型)腋窝淋巴结转移相关因素的病例对照研究

Objective To explore the difference in clinicopathological characteristics between invasive mi -cropapillary carcinoma (IMPC) and invasive carcinoma of no special type (NST), and analyze its association with axillary lymph node metastasis .Methods The clinicopathological data of 92 IMPC cases treated within the period from August 2010 to August 2013 in Peking Union Medical College Hospital were retrospectively analyzed . From patients in the same period , 368 NST cases were randomly selected as control group .The difference in clin-icopathological characteristics between IMPC and NST were compared , and the factors associated with axillarynlymph node metastasis were analyzed .Results There were significant differences in tumor size [ ( 2.9 ± 1.9) cm vs.(2.1 ±1.4) cm, P=0.001], lymph-vascular invasion rate (85.9% vs.6.0%, P<0.001), axillary lymph node metastatic rate (71.7%vs.47.3%, P<0.001), number of involved lymph node (8.2 ± 9.9 vs.2.9 ±5.7 , P<0.001 ) , progestogen receptor expression ( P=0.047 ) , human epidermal growth factor receptor-2 (HER-2) expression (P=0.009), Ki-67 index (P<0.001), TNM staging (P<0.001), and mo-lecular subtype ( P<0.001 ) between IMPC and NST .The axillary lymph node metastatic rates of tumor contai-ning ≤24%, 25%-49%, 50%-75% and ≥76% IMPC component were 73.9%, 56.3%, 72.2% and 77.1%, respectively .The axillary lymph node metastatic rate was not correlated with the percentage of IMPC component ( P=0.347 ) , but correlated with T-staging ( P=0.001 ) , HER-2 expression ( P=0.029 ) , molecu-lar subtype ( P=0.003 ) , P53 expression ( P=0.003 ) , and Ki-67 index ( P=0.045 ) .The axillary lymph node metastasis of NST was found correlated with T-staging ( P<0.001 ) , histological grade ( P =0.001 ) , lymph-vascular invasion ( P<0.001 ) , estrogen receptor αexpression ( P=0.007 ) , progestogen receptor expres-sion ( P=0.031 ) , HER-2 expression ( P=0.008 ) , and molecular subtype ( P<0.001 ) .Conclusions IMPC is a distinct variant of invasive breast carcinoma with a high propensity for lymph -vascular invasion and axillary lymph node involvement .IMPC and NST have different clinicopathological characteristics .The percentage of IMPC component does not correlate with axillary lymph node metastasis .Compared with NST , there are less clini-copathological determinants for axillary lymph node metastasis in IMPC .

Invasive micropapillary carcinoma of the male breast: Case report and review of the literature

Abstract Background Invasive micropapillary carcinoma (IMPC) of the breast is a rare and aggressive variant of invasive ductal carcinoma. IMPC has been reported to account for 3–6% of all breast cancers, and these tumors have been associated with a strong tendency to invade lymphatics with early spread to regional lymph nodes. Patients and methods We present a case of this rare type of breast cancer diagnosed in a male patient and summarize the current literature to date. Results Review of the literature on invasive micropapillary breast carcinoma revealed 27 retrospective cohort studies and case series. Significant heterogeneity of inclusion criteria and follow up data prevented meta-analysis. Tumors with an IMPC component demonstrated an early and high rate of lymphatic metastasis compared to invasive ductal carcinoma, however, no significant association was found between IMPC and decreased overall survival. Conclusions The IMPC data currently available indicates a strong trend towards a higher initial stage at diagnosis and possibly an increased risk of loco-regional recurrence, but remains underpowered to elucidate the prognostic effect of IMPC phenotype on survival. Further studies are warranted to establish the potential of this unique histologic phenotype to serve as a prognostic indicator and guide tumor-specific oncologic therapy.

Invasive micropapillary carcinoma of the extrahepatic bile duct and its malignant potential.

Invasive micropapillary carcinoma (IMPC) was originally described as a distinctive type of invasive carcinoma in the breast, but it has not been recognized as a histological type of the extrahepatic bile duct cancer. The present study demonstrated clinicopathological features and patient prognosis of IMPC. We examined histological reviews of 93 consecutive cases of the extrahepatic bile duct cancer and identified 13 cases which included IMPC component. The component of IMPC ranged from 5 to 60% of the primary tumor tissue, which was mainly detected at the invasive front of the tumor. Of the 13 cases, 12 (92.3%) carcinomas with IMPC showed lymph node metastasis more frequently compared to conventional adenocarcinoma (39.2%, P<0.001). Presence of IMPC component was significantly associated with poor overall survival (P=0.003). In conclusion, extrahepatic bile duct carcinoma with IMPC component showed significant lymphatic invasion, lymph node metastasis, and resulted in poor prognosis.

A case of advanced gastric cancer with an invasive micropapillary carcinoma component

A case of advanced gastric cancer with an invasive micropapillary carcinoma component

Relationship between colorectal adenocarcinoma with invasive micropapillary carcinoma component and lymph node metastasis

To investigate the relationship between colorectal adenocarcinoma with invasive micropapillary carcinoma (IMPC) component, lymphovascular invasion, and lymph node metastasis. One hundred and thirty one cases of colorectal adenocarcinoma with invasive micropapillary carcinoma component were evaluated by H&E and immunohistochemical staining. The main pathological features, percentage of IMPC component, lymphovascular invasion, and lymph node metastasis were assessed and compared to 296 cases of conventional colorectal adenocarcinoma. The maximum diameter of the tumors of the IMPC group was significantly lower than the conventional group. The degree of differentiation, the lymph node metastatic rate, the average number of metastatic lymph nodes, the number of cases with lymphovascular tumor emboli were significantly higher in the IMPC group (P = 0.000). The rate of distant metastasis at operation was higher in the IMPC group (14.5%) compared to the conventional group (10.8%) even though statistical significance was not achieved (P = 0.278) . In IMPC group, as the IMPC component increased, the rate of lymph node metastasis also showed an increasing trend. The rate of lymph node metastasis were 53.0% (157/296) , 67.7% (42/62) and 85.5% (59/69) " respectively" for conventional adenocarcinoma, adenocarcinoma with ≤ 10% IMPC component and adenocarcinoma with > 10% IMPC component; the difference was statistically significant (P = 0.000). Compared to conventional colorectal adenocarcinomas, the colorectal carcinomas with IMPC component show a significantly higher rate of lymphovascular invasion, lymph node metastasis and distant metastasis. The percentage of IMPC component in colorectal adenocarcinoma is significantly correlated to the rate of lymph node metastasis. Therefore, presence of IMPC component and degree of tumor differentiation are predicting factors of lymph node metastasis.

Abstract P1-01-20: Clinicopathlogic Analysis of Invasive Breast Carcinoma with Micropapillary Component

Abstract Background: Invasive micropapillary carcinoma(IMPC) is a rare variant of invasive breast cancer that is associated with a high incidence of lymph node(LN) metastasis. But, the meaning of focal micropapillary component has not been fully elucidated. Methods: We retrospectively reviewed 88 invasive breast carcinoma cases with IMPC and focal micropapillary component. Results: Sixty-four cases had micropapillary component only in operative specimens, 18 cases had only in core-needle specimens, and 6 cases had in both. Sixteen were diagnosed as IMPC, and 72 cases had focal micropapillary component with other histological type of invasive breast carcinoma; 65 cases with invasive ductal carcinoma, 6 cases with mucinous carcinoma and one with metaplastic carcinoma. There was one male patient. Mean age was 56.5 years old. Median tumor size was 2.5 cm. Forty two (47.7%) cases were nuclear grade(NG)1, 16 (18.2%) were NG2 and 30 (34.1%) were NG3. Seventy eight cases (90%) were ERand/orPgR positive and 18.5% were HER2 positive. Six cases had distant metastasis at initial diagnosis. LN metastases were observed in 63.6% of all cases, and this high rate of LN metastasis could be seen even in small tumor group; 45.5% in cases with tumor equal or less than 2 cm. In the group of IMPC, 40.0% had LN metastasis, and 56.9% in cases with focal micropapillary component. There was no significant difference between IMPC and focal micropapillary component by univariate analysis(p = 0.055). Multivariate analysis of all cases showed that tumor size(&amp;gt;2cm)(p = 0.047), NG(1 vs 2&amp;3, p = 0.017), and lymphatic invasion(p = 0.001) were significantly associated with LN metastasis. No significant difference between IMPC and focal micropapillary component was showed by multivariate analysis also (p = 0.60). Hormone receptor status or HER2 status were also not correlated(p = 0.92, p = 0.27 respectively). Among female patients without neoadjuvant chemotherapy, sentinel lymph node biopsy(SLNB) were underwent in 38 cases, and 16 cases (42.1%) had positive sentinel lymph node(SLN). Fourteen patients underwent additional axillary dissection and 7 cases (50%) had non-SLN metastases. Among patients with SLNB, 12 patients had micropapillary component in needle biopsy specimens, and 6 (50%) cases had positive SLN. Conclusion: Our data showed very high rate of LN metastasis in patients with micropapillary component, and this tendency still exists in cases with only focal micropapillary pattern. High positivity of SLNB was observed in these groups, and our data suggests that the findings of micropapillary component in CNB specimen could be used as a predictor of SLN metastasis. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-01-20.

Gastric carcinoma with invasive micropapillary pattern and its association with lymph node metastasis

This study aimed to characterize the clinicopathological features of invasive micropapillary carcinoma (IMPC) of the stomach. Seventeen cases of gastric IMPC were identified from histological reviews of 1178 consecutive cases. IMPC components occupied 10-90% of the entire tumours. Fifteen tumours showed invasion into the muscularis propria or deeper, whereas two tumours were limited to the submucosa. All 17 cases were associated with tubular or papillary adenocarcinoma. Lymphatic and venous invasion were identified more frequently in cases with IMPC components than in those without (P = 0.0023 and P = 0.0009, respectively). Nodal metastases were identified in 14 of 17 (82%) cases with IMPC components, whereas they were detected in 540 of 1161 (47%) cases with no IMPC components (P = 0.0053). Multivariate analysis demonstrated that the presence of IMPC was an independent predictor of nodal metastasis. Conservative treatments, such as endoscopic resection, should not be used for gastric carcinoma with IMPC components, as these cases are associated with a high propensity for lymphovascular invasion and nodal metastasis.

Clinicopathological significance of invasive micropapillary carcinoma component in invasive breast carcinoma

Invasive micropapillary carcinoma (IMP) of the breast is a rare variant of invasive breast carcinoma and most cases of IMP are associated with nodal metastasis and lymphatic invasion. Lesions composed of an IMP component alone are rare and almost always coexist with other pathological components. However, few reports have documented IMP along with its proportion and the coexistent pathological type. We analyzed the total 486 breast cancer lesions operated in our hospital in 1998. We classified the lesions into five groups by the proportion of the IMP component in each lesion. Then we evaluated the incidence of nodal metastasis and lymphatic invasion in each group. The incidence of the invasive carcinoma containing any IMP components was 8.4%. The incidence of nodal metastasis and lymphatic invasion in lesions with an IMP component were significantly higher than that in those with no IMP. No correlation was seen between the incidence of nodal metastasis and the coexistent pathological type, shape of tumor clusters, nuclear grade and the expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 and gross cystic disease fluid protein-15 in IMP components. The presence of IMP components was a significant predictive factor for nodal metastasis, even if it is detected in only a small proportion of the tumor.

Characteristic Morphology of Invasive Micropapillary Carcinoma of the Breast: An Immunohistochemical Analysis

Invasive micropapillary carcinoma of the breast is a distinct variant of breast cancer. In the present study, we analyzed potential immunophenotypic changes in invasive micropapillary carcinoma. Specimens from 15 patients with invasive micropapillary carcinoma were analyzed using clinicopathological and immunohistochemical methods. We also examined the relationship between clinicopathological factors using the Ki-67 labeling index. Immunohistochemical staining for cytoplasmic p63 expression was seen in four (27%) tumors, and p63 nuclear expression was also observed in four (27%) tumors. Involucrin and 34betaE12 were expressed in the invasive micropapillary carcinoma component of nine (60%) and four (27%) tumors, respectively. Cytokeratin 5/6 was expressed in three (20%) tumors and cytokeratin 14 staining was negative in all tumors. In one tumor (case 3), vimentin, epithelial membrane antigen and cytokeratin 8/18 were co-expressed. Four tumors (27%) were negative for the estrogen receptor/progesterone receptor/HER2. However, 11 out of 15 (73%) tumors were positive for the estrogen receptor. The Ki-67 labeling index was significantly higher in cases with p63 tumor expression than in those without (P < 0.0001), and also higher in cases with lymph node metastasis than in cases without (P = 0.0029). Nuclear expression of p63, involucrin and 34betaE12 were detected indicating squamous differentiation. Cytoplasmic p63 expression was also identified. The fact that the Ki-67 labeling index was significantly higher in such cases may have been associated with the aggressive behavior of these tumors. Our findings suggest that the characteristic morphology of invasive micropapillary carcinomas may be due to immunophenotypical and oncogenic changes.

Increased expression of SDF‐1/CXCR4 is associated with lymph node metastasis of invasive micropapillary carcinoma of the breast

Stromal cell-derived factor-1 (SDF-1) and its receptor CXCR4 are implicated in tumour chemotaxis and metastasis. The aim was to examine their roles in the metastasis of invasive micropapillary carcinoma (IMPC) of the breast, a tumour with a high propensity for nodal spread. We compared the expression of SDF-1 and CXCR4 in 103 cases of breast cancer containing IMPC components with a control group of 96 cases of invasive ductal carcinoma (IDC), not otherwise specified type by immunohistochemistry and chemical in situ hybridization (CISH). The results showed that the predominant cytoplasmic expression of both SDF-1 and CXCR4 was greater in tumour cells of the IMPC components than in those of the non-IMPC components and the control IDC cases, and was correlated significantly with the number of positive lymph nodes (P < 0.05). SDF-1 expression on cell membranes was less frequently identified in IMPC than IDC (P = 0.021). Immunohistochemical detection of SDF-1 in endothelial cells of lymphatic vessels was more common in IMPC (P = 0.007) and correlated significantly with lymph node status (P = 0.002), although SDF-1 mRNA was rarely detected by CISH. This study suggests that up-regulation of cytoplasmic expression of SDF-1/CXCR4 might be one of the molecular mechanisms facilitating lymph node metastasis of IMPC.

Luminal group may give more benefit for invasive micropapillary carcinoma component breast cancer patients: experience from Cancer Hospital Fudan University.

Abstract Abstract #6152 Objective: Comparative studies on clinical features and outcomes of very rare invasive micropapillary carcinoma of breast cancer of 4 subtypes by immunohistochemistry staining.&amp;#x2028; Methods: From Aug 2005 to Mar 2008, a total of 52 breast cancer patients(BCPs) with an invasive micropapillary component (IMPC) among 1951 Chinese BCPs with complete of clinicopathologic data in our institution were enrolled into a retrospective analysis. We characterized all these 52 patients and analyzed using various parameters.&amp;#x2028; Results: The 52 cases of breast carcinoma with an IMPC all occurred in women. Mean age was 51 years (range from 26-82). All of these patients had breast masses; one also had metastasis to the supraclavicular lymph node at the time of diagnosis., mean tumor size was 2.83cm(T2), 23.08%(12/52) was pure invasive micropapillary carcinoma, and lymph node positive percentage was 75.59 %( 36/51).Fifty one patients received surgery, while one of them lost the chance of surgery. Forty of them received the modified mastectomy while one was performed lumpectomy due to old age. One was performed LAND alone and four were performed lumpectomy and sentinel lymph node biopsy.&amp;#x2028; By using IHC staining, when we regard HER2/neu 0 and +as negative. The Luminal A group, Luminal B, trip-negative, HER2+ /ER- were 76.92% (40/52), 11.54 %( 6/52), 7.69 %( 4/52), 3.85 %( 2/52), respectively. Compared to the database of 2005 breast cancer carcinoma in our institution, there was more Luminal A group patients than the whole group (P=0.01, chi-square test.), more Luminal B (P=0.028, Fisher exact possibility test), less trip-negative group (P=0.001, chi-square test). The positive lymph node among the Luminal A group, Luminal B, trip-negative, HER2+ /ER- were 65%,80%, 100%, 100%, respectively, while the lymphvascular invasion were 55%,33.33%,50%,50%,respectively, Mulifocality in Luminal A was 25% , 16.67% in Luminal B , while 50% in both trip-negative and HER2+/ER-.&amp;#x2028; Twenty-one of them received both anthracyclines and Taxane, while 27 only received anthracyclines, Four patients only were received only AIs due to old age. All the luminal group patients received endrocine therapy after chemo. After nearly 14 months (2∼34 months) follow up, thirty-six women were disease free, one had local recurrence, and 1 had lung metastasis, while 1 had ovary carcinoma when the diagnosis of breast malignant, one patient lost following up due to mental disorder. Among the luminal B, one had metastasis when diagnosis, others were disease free. One woman of the trip-negative died of non-breast cancer disease,the HER2+/ER- group was no recurrence or metastasis.&amp;#x2028; Discussion: The prelimary results showed that more luminal group in the IMPC may get benefit from the endocrine therapy. However the number of these cases is small and follow-up time is not very long, further studies are necessary to explain these rare and unique pattern of invasive carcinoma. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6152.

Diagnosis and prognosis study of breast carcinoma with micropapillary component

To study the diagnostic criteria, clinicopathologic characteristics and prognosis of invasive micropapillary carcinoma (IMPC) of breast. All cases of breast carcinoma diagnosed during the period from 1989 to 2001 were retrospectively reviewed. One hundred examples with IMPC component, according to the 2003 World Health Organization classification of breast tumors, were identified. The clinicopathologic features and follow-up data of these cases were analyzed. Amongst the 100 cases of IMPC studied, 69% (69/100) had evidence of lymphovascular invasion. The incidence of regional lymph node metastasis was 84.8% (84/99). Follow-up information was available in 98 patients (mean of follow-up duration = 60.1 months). Eleven patients (11.2%) had local recurrence within a mean of 26.4 months after the operation, while 38 patients (38.8%) had distant metastases within a mean of 36.0 months. Thirty-six patients (36.7%) died of the disease. The overall 5-year survival rate was 59% and the 10-year survival rate was 48%. Univariate and multivariate analysis showed that the prognosis of patients was adversely affected by the presence of lymphovascular invasion and family history of breast cancer. On the other hand, tamoxifen therapy and adjuvant chemotherapy improved survival. Breast carcinoma with IMPC component is associated with poor prognosis, despites the relative proportion of this architectural pattern. The overall prognosis is related to the presence of lymphovascular invasion and family history of breast cancer. Hormonal therapy and individualized chemotherapy can improve the survival rate.

Invasive Micropapillary Carcinoma of the Breast : Association of Pathologic Features With Lymph Node Metastasis

Invasive micropapillary carcinoma (IMPC) of the breast is characterized by a high incidence of axillary lymph node metastasis. To investigate the relationship between pathologic features and lymph node metastasis, 51 cases of breast carcinoma with IMPC components were studied. Immunohistochemical analysis for vascular endothelial growth factor (VEGF)-C and VEGF receptor (VEGFR)-3 was performed, and lymphatic vessel density was measured. The main findings included a significantly increased number of positive lymph nodes and/or an increased rate of lymph node metastasis in IMPC with a higher histologic grade, prominent stromal infiltration of lymphocytes, and higher VEGF-C expression and lymphatic vessel density. The percentage of IMPC component in the tumor was not associated with the incidence of lymph node metastasis. The results suggest that the histologic grade, lymphatic vessel density, and lymphocyte infiltration of IMPC are the key factors that influence lymph node metastasis. Further studies are required to elucidate the mechanisms underlying the lymphotropism of this distinct variant of breast carcinoma.