Invasive Micropapillary Carcinoma Research Articles

Similar prognoses for invasive micropapillary breast carcinoma and pure invasive ductal carcinoma: a retrospectively matched cohort study in China.

PurposeInvasive micropapillary breast carcinoma (IMPC) is a rare pathological finding. Few studies have compared IMPC with invasive ductal breast carcinoma (IDC) according to matched nodal status and age. To better illustrate the difference between IMPC and IDC prognoses, we conducted this cohort study.Methods51 mixed or pure IMPC patients and 102 pure IDC patients were matched for nodal status and age. Clinical and biological features as well as disease-free survival (DFS) were compared between groups.ResultsMore than one-half of IMPC consisted of mostly or exclusively IMPC component (meaning greater than 75%) and these tumors significantly correlated with a higher histologic grade (P = 0.016) and LVI positivity (P = 0.036) compared with mixed IMPC. IMPC displayed a significantly higher rate of estrogen receptor (ER) positivity and lymphovascular invasion (LVI) compared to matched IDC. Women diagnosed with IMPC had a slight, but not significant, reduced frequency for recurrence and metastasis compared to women with IDC (15.7% vs. 21.6%, P = 0.518). In the subgroup analysis, IMPC patients demonstrated significantly reduced survival (P = 0.018) compared to IDC patients in the T1N2–3 subpopulation, whereas IDC patients demonstrated significantly increased recurrence and metastasis (P = 0.024) compared to IMPC patients in the T2N2–3 subgroup. No difference was observed in patients with 3 or less positive lymph nodes (LNs).ConclusionAlthough no difference in DFS was observed between IMPC and LN-matched IDC patients, IMPC patients demonstrated a significantly poorer outcome compared to IDC patients with smaller tumors and 4 or more positive LNs. The opposite results were observed in larger tumors and patients with 4 or more positive LNs. Therefore, we might advise more proactive treatment for IMPC patients with a smaller tumor size and extensive LN involvement. Furthermore, correlative IMPC studies should focus on this subset of patients to elucidate the genetic and/or biologic differences that contribute to metastatic potential.

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.

Absence of caveolin-1 expression in carcinoma-associated fibroblasts of invasive micropapillary carcinoma of the breast predicts poor patient outcome.

Caveolin-1 (Cav-1) expression in stromal carcinoma-associated fibroblasts (CAFs) has been associated with tumor progression and clinical outcome. This study was undertaken to assess its prognostic significance in invasive micropapillary carcinoma of the breast (IMPC), a tumor with abundant stromal CAFs and a high tendency for nodal metastasis and poor outcome. Cav-1 expression was studied by immunohistochemistry in a group of 86 cases of IMPC along with a control group of 105 cases of invasive ductal carcinoma, not otherwise specified (IDC-NOS). Our results indicate that absence of Cav-1 expression in CAFs of IMPC is more common than in IDC-NOS (57 %, 49/86 vs. 36 %, 38/105). The absence of expression was associated with larger tumor size and higher lymph node stage (P < 0.05) of IMPC. Univariate analysis suggested absence of Cav-1 in CAFs to be a candidate independent predictor of reduced progression-free survival (PFS) (HR = 3.945, 95 % CI = 1.717-9.063, P = 0.001), which was confirmed by multivariable analysis (P = 0.018). In patients with IMPC spreading to local lymph nodes, loss of stromal Cav-1 predicted a fourfold increase in risk for shortened PFS. In contrast, no significant difference of tumor epithelial Cav-1 expression was found between IMPC and IDC-NOS, and the expression of tumor Cav-1 was not significantly associated with the prognosis of patients with IMPC. Absence of Cav-1 expression in CAFs is a strong prognostic factor for IMPC patients, and it may further subgroup the patients with lymph node metastasis to guide clinical management.

Clinico-pathological features and prognosis of invasive micropapillary carcinoma compared to invasive ductal carcinoma: a population-based study from China.

BackgroundInvasive micropapillary carcinoma (IMPC) of the breast is a rare subtype of breast cancer that is associated with a high incidence of regional lymph node metastases and a poor clinical outcome. However, the clinico-pathological features and prognostic factors of IMPC are not well understood.Patients and MethodsA total of 188 IMPC cases and 1,289 invasive ductal carcinoma (IDC) cases were included. The clinical features, breast cancer-specific survival (BCSS) and recurrence/metastasis-free survival (RFS) of the patients were compared between these two groups.ResultsThe IMPC patients exhibited more features of aggressive carcinoma than the IDC patients, including larger tumor size, higher tumor stage, a greater proportion of nodal involvement and an increased incidence of lymphovascular invasion. Patients with IMPC had lower 5-year BCSS and RFS rates (75.9% and 67.1%, respectively) than patients with IDC (89.5% and 84.5%, respectively). Compared to IDC patients, the patients with IMPC had a significantly higher percentage of stage III breast cancer (51.3% versus 21.7%). In a stage-matched Kaplan-Meier analysis, the patients with stage III IMPC had lower 5-year BCSS and RFS rates than patients with stage III IDC (BCSS, P = 0.004; RFS, P = 0.034). A multivariate analysis revealed that TNM stage was an independent prognostic factor for patients with IMPC. The proportion of cancers with a luminal-like subtype was significantly higher in IMPC than in IDC (P<0.001). However, after matching by molecular subtype, the patients with IMPC had significantly worse clinical outcomes than patients with IDC.ConclusionsIn Chinese women, IMPCs displayed more aggressive behaviors than IDCs, resulting in poorer clinical outcomes for patients with IMPC, regardless of a favorable molecular subtype. Our findings illustrate that the poorer survival of patients with IMPC might be due to an increased incidence and aggressiveness of tumors in TNM stage III.

Pure invasive micropapillary carcinoma of the male breast: Report of a rare case with C-MYC amplification

Male breast cancer is rare. The most common histological subtypes include invasive carcinoma “of no special type” and papillary carcinoma. Other variants, including pure micropapillary carcinoma, have been described as well but are extremely rare. Pure micropapillary carcinoma has been recently characterized by a C-MYC gene amplification in women.We report here, occurring in a 73-year-old man, the first case of pure micropapillary carcinoma with amplification of the C-MYC gene.

Mammographic, sonographic and MR imaging features of invasive micropapillary breast cancer

PurposeDescribe mammographic, sonographic and MRI findings of invasive micropapillary carcinoma (IMPC) of the breast. Materials and methodsReview of the pathology database identified 43 patients (mean age, 59.3 years) with the diagnosis of breast IMPC. Three patients had no available imaging studies. Mammograms (40), breast ultrasounds (33) and MRIs (8) were retrospectively evaluated by two radiologists in consensus following the BI-RADS Lexicon. Clinical, histopathologic features, as well as hormone status were recorded. ResultsTwenty patients presented with palpable abnormality (20/40, 50%). Thirty-five patients had an abnormal mammogram (87.5%, 35/40) showing 39 lesions, 29 corresponding to masses (29/39, 74.4%), 11 associated with microcalcifications and two associated with architectural distortion. Sonography identified 41 masses (in 33 patients) displaying an irregular shape (30/41, 73.2%), appearing hypoechoic (39/41, 95%), with spiculated or angular margins (26/41, 63.4%), non-parallel orientation (26/41, 63.4%) and combined acoustic posterior pattern (18/41, 44%). MRI identified 13 lesions (in eight patients), 12 as masses (12/13, 92.3%) with irregular or spiculated margins (12/12, 100%), eight displaying an irregular or lobulated shape (8/12, 66.7%), six with homogeneous internal enhancement (6/12, 50%) and eight with type 3 enhancement curve (8/12, 61.5%). Associated non-mass like enhancement was noted in two patients. Twenty-nine patients had associated lymphovascular invasion (29/40, 72.5%) and axillary lymph node metastases were present in 22 of the 39 patients (22/39, 56%). ConclusionInvasive ductal carcinoma with IMPC features display imaging findings highly suspicious of malignant lesions. They are associated with high lymphovascular invasion and lymph node metastases rates.

Polarity gene alterations in pure invasive micropapillary carcinomas of the breast.

IntroductionPure invasive micropapillary carcinoma (IMPC) is a special type of breast carcinoma characterised by clusters of cells presenting polarity abnormalities. The biological alterations underlying this pattern remain unknown.MethodsPangenomic analysis (n = 39), TP53 (n = 43) and PIK3CA (n = 41) sequencing in a series of IMPCs were performed. A subset of cases was also analysed with whole-exome sequencing (n = 4) and RNA sequencing (n = 6). Copy number variation profiles were compared with those of oestrogen receptors and grade-matched invasive ductal carcinomas (IDCs) of no special type.ResultsUnsupervised analysis of genomic data distinguished two IMPC subsets: one (Sawtooth/8/16) exhibited a significant increase in 16p gains (71%), and the other (Firestorm/Amplifier) was characterised by a high frequency of 8q (35%), 17q (20% to 46%) and 20q (23% to 30%) amplifications and 17p loss (74%). TP53 mutations (10%) were more frequently identified in the amplifier subset, and PIK3CA mutations (4%) were detected in both subsets. Compared to IDC, IMPC exhibited specific loss of the 6q16-q22 region (45%), which is associated with downregulation of FOXO3 and SEC63 gene expression. SEC63 and FOXO3 missense mutations were identified in one case each (2%). Whole-exome sequencing combined with RNA sequencing of IMPC allowed us to identify somatic mutations in genes involved in polarity, DNAH9 and FMN2 (8% and 2%, respectively) or ciliogenesis, BBS12 and BBS9 (2% each) or genes coding for endoplasmic reticulum protein, HSP90B1 and SPTLC3 (2% each) and cytoskeleton, UBR4 and PTPN21 (2% each), regardless of the genomic subset. The intracellular biological function of the mutated genes identified by gene ontology analysis suggests a driving role in the clinicopathological characteristics of IMPC.ConclusionIn our comprehensive molecular analysis of IMPC, we identified numerous genomic alterations without any recurrent fusion genes. Recurrent somatic mutations of genes participating in cellular polarity and shape suggest that they, together with other biological alterations (such as epigenetic modifications and stromal alterations), could contribute to the morphological pattern of IMPC. Though none of the individual abnormalities demonstrated specificity for IMPC, whether their combination in IMPC may have a cumulative effect that drives the abnormal polarity of IMPC needs to be examined further with in vitro experiments.

Adenocarcinoma of the paraurethral glands: a case report.

Adenocarcinoma of the paraurethral glands represents a very rare neoplasm of the urinary tract. Due to the rarity of this disease, there is no standard therapeutic approach. We report a case of adenocarcinoma of the paraurethral glands in a 56-year-old woman, presenting with abnormal serous vaginal discharges. The radiologic examination revealed a 5-cm mass around the urethra, which underwent surgical resection. After surgical resection, the histology revealed a moderately differentiated adenocarcinoma, probably arising from the paraurethral glands. One month later, a pelvic recurrent mass was radiologically diagnosed; consequently, an anterior pelvic exenteration with lymph node dissection was performed. Histological examination revealed a moderately differentiated adenocarcinoma, with glandular and micropapillary architecture, with multiple lymph node metastases. The absence of modifications such as urethritis cystic glandularis on the urethral mucosa, as well as the lack of a lesion in situ, associated with the immunohistochemical expression of PAX8 and negativity for GATA3 and S100p, suggested that the adenocarcinoma originated from the paraurethral glands rather than from the urethral mucosa. Post-surgery CT scans revealed no evidence of metastatic disease. The patient received 6 courses of adjuvant chemotherapy with carboplatin and paclitaxel. One year after the pelvic exenteration, because of inguinal lymph node progression, an inguinal lymphadenectomy was performed. Four months later, a TC-PET revealed a multidistrectual lymph node and a lung micronodule disease progression. Invasive micropapillary carcinomas have been characterized as a rare distinctive variant of carcinomas in several anatomic sites and are distinguished by a marked tendency to lymphovascular invasion, justifying the association with high-stage disease and poor prognosis. In the present case, both the poor prognosis connected with micropapillary structure and the lymph node involvement, encouraged adjuvant cisplatinum-based chemotherapy.

A case of invasive micropapillary carcinoma of the breast involving extensive lymph node metastasis

We herein report a case of invasive micropapillary carcinoma (IMPC) involving extensive lymph node metastasis with no recurrence for over 7 years. A 41-year-old female presented with pain and a swelling mass in the left axillary region, which had been present for several months. The tumor measured 1.6 cm in diameter in the middle of upper area of the left breast. Based on the findings of a core needle biopsy the pathological diagnosis was IMPC or mucinous carcinoma. The cytology of the left axillary lymph node was positive for metastatic carcinoma. The patient underwent a left mastectomy and a left axillary dissection (level I to III). The postoperative pathological diagnosis was IMPC with mucin production, and the number of metastatic lymph nodes was 59. The patient was given adjuvant chemotherapy (four courses of 5-fluorouracil, epirubicin and cyclophosphamide (FEC) and four courses of docetaxel), radiation for the left chest wall, supraclavicular and internal thoracic area, and then received tamoxifen for 5 years. The patient has remained recurrence-free for over 7 years. IMPC is known to be an aggressive histological type associated with a high incidence of lymph node metastasis and a poor prognosis. It seems that long-term survival was obtained by performing sufficient medical treatment. Prognostic factors other than the number of lymph node metastases may also exist.

Invasive micropapillary carcinoma: a distinct type of adenocarcinomas in the gastrointestinal tract.

Invasive micropapillary carcinoma (IMPC) is a rare histological type of tumor, first described in invasive ductal breast cancer, than in malignancies in other organs such as lungs, urinary bladder, ovaries or salivary glands. Recent literature data shows that this histological lesion has also been found in cancers of the gastrointestinal system. The micropapillary components are clusters of neoplastic cells that closely adhere to each other and are located in distinct empty spaces. Moreover, clusters of neoplastic cells do not have a fibrous-vascular core. The IMPC cells show reverse polarity resulting in typical ''inside-out'' structures that determines secretary properties, disturbs adhesion and conditions grade of malignancy in gastrointestinal (GI) tract. Invasive micropapillary carcinoma in this location is associated with metastases to local lymph nodes and lymphovascular invasion. IMPC can be a prognostic factor for patients with cancers of the stomach, pancreas and with colorectal cancer since it is related with disease-free and overall survival. The purpose of this review is to present the characterization of invasive micropapillary carcinoma in colon, rectum, stomach and others site of GI tract, and to determine the immunohistological indentification of IMPC in those localization.

EP-1235: Prognostic factor and failure pattern differences between invasive micropapillary carcinoma and IDC of the breast

Conclusions: The value of IMRT still stands in more complex breast planning and results in better homogeneity and less dose exposure to lungs and heart, reducing side effects and conserving good cosmetic outcome after breast conservative surgery. Planning is time-consuming and a designed IMRT template is useful, including strict constraints and creation of central avoiding structures around the heart. Time and costs of complex planning are largely compensated by gain in quality of life and reduced overall treatment times (15 fractions only).

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

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

術前化学療法が奏効し乳房温存療法を施行した乳腺浸潤性微小乳頭癌の１例

症例は56歳，女性．左乳房腫瘤と左腋窩リンパ節を触知し，細胞診で腫瘤および腋窩リンパ節から悪性所見が得られた．針生検で乳腺浸潤性微小乳頭癌（IMPC）と診断され，ER陽性，PgR陽性，Her2陰性，Ki67 35.2％であった．術前化学療法（EC4，PTX12）を施行し，CTでは原発巣，リンパ節ともCRの状態になり，乳房温存術およびリンパ節郭清術を施行した．病理検査で腫瘍のほとんどは肉芽腫様組織や線維化巣となり，リンパ節に転移を認めなかった．術後照射とAI剤の投与を開始し，術後３年７カ月後の現在，再発の徴候なく経過している．本症は予後不良とされ，乳房切除術を施行される例が多いが，本例のように化学療法が奏効し，ER陽性例に対しては乳房温存療法および術後内分泌療法も選択肢になりえることが示唆される．

Application of ultrasonography in diagnosing and preoperative TNM staging for invasive micropapillary carcinoma of breast

Objective To investigate the ultrasonic characteristics of invasive micropapillary carcinoma(IMPC) of breast and the metastatic lymph nodes,and to evaluate the value of ultrasonography for preoperative TNM staging.Methods The ultrasonic characteristics of 16 IMPC and 81 invasive ductal carcinoma (IDC) confirmed by pathology,as well as the metastatic lymph nodes were analyzed retrospectively.The TNM-staging for IMPC by preoperative ultrasonography was evaluated according to pathology.Results Compared with IDC group,the masses showed higher A/T ratio (＜ 0.7),larger maximum diameter,more calcification,unclear border and lymph node metastasis rate,while less acoustic halo in IMPC group.Meanwhile,similar ultrasonic characteristics,such as irregular shape,uneven internal echo,spiculate margin,posterior acoustic attenuation and internal blood flow were seen in IMPC and IDC groups (P ＞0.05).According to pathology,the ultrasonic coincidence rate for T staging was 56.3 ％,and T2-staging was 85.7％.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic diagnosis on lymph node metastases was 70.0％,83.3％,87.5％ and 62.5％,respectively.Conclusions Ultrasonography displayed more typical malignant signs,higher lymph node metastasis rate and diagnosis accuracy for IMPC,which possessed certain value for preoperative TNM staging. Key words: Ultrasonography; Breast neoplasms; Neoplasm staging

Abstract P4-05-14: Molecular and immunohistochemical profile of invasive micropapillary breast carcinoma

Abstract Background: Invasive micropapillary carcinoma (IMPC) of the breast is an uncommon disease subtype that is generally considered aggressive. A variety of carcinomas can exhibit micropapillary histology including lung, bladder, and ovary. Immunohistochemical (IHC) and genomic studies at these other organ sites have identified potential therapeutic targets including BRAF mutations. The purpose of this study was to characterize the IHC and molecular profile of a cohort of IMPC that could suggest potentially useful targeted therapies. Design: Eight tumor blocks (from seven patients) of IMPC were identified from the archives at the University of Iowa Hospitals and Clinics from 1997-2012. IHC stains for ER, PR, HER2, PTEN (Dako; clone 6H2.1, 1:100) and NM23H1 (Santa Cruz Biotechnology, clone: Nm301, 1:50) were performed. ER, PR, and HER2 were score according to ASCO/CAP guidelines. PTEN and NM23H1 were scored using a 4-tier system: P: strong homogenous; H: heterogeneous (positive with negative foci); R: reduced in more than 50%; and L: lost in all or majority. Genomic DNA was isolated from the formalin fixed paraffin embedded tumor samples used for IHC. BRAF V600 mutational analysis was analyzed using a laboratory-developed primer extension assay. Massive parallel sequencing (next generation sequencing, NGS) was performed using the Ion AmpliSeq™ Cancer Hotspot Panel v2 (Life Technologies, Carlsbad, CA). Results: The patients were 50-83 years of age. Six had Elston-Ellis Grade II tumors and one was Elston-Ellis grade I. Four patients had axillary lymph node metastases. All cases examined showed strong and diffuse estrogen and progesterone receptor expression with no over-expression of HER2. Complete PTEN loss was observed in 4 cases including 3 with lymph node positive disease, three of these four cases had concurrent reduced expression of NM23H1. No mutations in exon 15 of the BRAF gene were detected. By NGS, one sample showed a KITc.A1621C (pM541) polymorphism, three had no mutations, and sequencing from the other three was unsatisfactory. Molecular and IHC Profile of Seven Patients with IMPC of the BreastHistologic GradeAxillary Lymph Node MetastasisER/PRHER2PTENNM23H1NGS2NoPositive/PositiveNegativePPUnsatisfactory1NoPositive/PositiveNegativeLRNegative2NoPositive/PositiveNegativeHPIntronic2YesPositive/PositiveNegativeHPUnsatisfactory2YesPositive/PositiveNegativeLRKIT c.A1621C (pM541)2YesPositive/PositiveNegativeLPNegative2YesPositive/PositiveNegativeLRUnsatisfactory Conclusions: Loss of PTEN expression was observed in 57% of cases (4/7) and was often associated with lymph node metastasis. A direct correlation between PTEN and NM23H1 expression was observed in six cases. No BRAF or other mutations were detected. PTEN was included in the NGS panel. Reduced expression observed in our study is most likely due to posttranscriptional modifications. Concurrent reduced expression of the metastatic suppressor NM23H1 may play a role in the clinical behavior of IMPC. The high frequency of PTEN loss may have implications for targeted therapy towards the PI3K pathway in this subgroup of patients. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-05-14.

Clinical, cytologic, and histologic features of a mammary micropapillary carcinoma in a dog

Mammary invasive micropapillary carcinoma is a rare variant of mammary carcinoma that was recently recognized in dogs. The cytologic features and biologic behavior of such neoplasms in dogs have not yet been widely discussed in the veterinary literature. We report the clinical, cytologic, and histologic features of a canine micropapillary carcinoma in a 13-year-old female mongrel dog. The mammary region presented with extreme local pain, severe edema and erythema, and multifocal epidermal ulceration, which is typical for an inflammatory mammary carcinoma. Fine-needle aspirates were highly cellular and consisted of individual cells and papillary cell clusters with characteristics of malignant epithelial cells. Histologic examination revealed neoplastic cells arranged in small papillae without fibrovascular cores, sometimes inside clear lymphatic spaces, indicating lymphovascular invasion. Regional lymph node evaluation revealed metastatic cells. Due to deteriorating clinical condition the dog was euthanatized 5 months after mastectomy. At necropsy, metastatic neoplastic mammary cells were found in popliteal and mediastinal lymph nodes, the right femoral biceps muscle, liver, heart, lungs, and urinary bladder.

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.

Invasive Micropapillary Carcinoma of the Breast: A Clinicopathologic Study of 103 Cases of an Unusual and Highly Aggressive Variant of Breast Carcinoma

Invasive micropapillary carcinoma (IMPC) of the breast is an uncommon, highly aggressive breast cancer that may occur in pure and mixed forms. Our aim in this study is to investigate the relationship between clinical, histopathologic, and immunohistochemical features of pure and mixed IMPC cases diagnosed and treated at our institution. One hundred and three IMPC cases diagnosed at our institution over a period of 19 years have been selected. Clinical, histopathologic features, as well as hormone status and c-erb-B2 overexpression of tumors were re-evaluated. Mann-Whitney U, chi-squared, Kaplan-Meier, and Fisher's exact tests were used for statistical analyses. Results were considered to be significant at p < 0.05. Twenty cases (19.4%) were pure, and 83 cases (80.6%) were mixed IMPC. The most common nonmicropapillary invasive carcinoma component in mixed cases was invasive ductal carcinoma (IDC; 78.3%). Progesterone receptor was significantly less positive in pure IMPC cases (p = 0.031). There was no statistically significant difference between the two groups, in terms of mean age of the patients (53.0 versus 52.8), mean tumor size (26.6 mm versus 27.7 mm), presence of high-grade tumor (p = 0.631), presence of sentinel lymph node (SN) metastasis (p = 1.000), axillary lymph node metastasis (p = 1.000), lymphatic invasion (p = 1.000) and blood vessel invasion (p = 0.475), c-erbB-2 overexpression of tumor cells (p = 0.616), distant metastasis (p = 0.549), or overall survival (p = 0.759). The local recurrence rate of the two groups was not statistically significant either (16.7% versus 4.3%). However, local recurrence was detected 12% more commonly (p = 0.100), and ~8 months earlier (p = 0.967) in pure IMPC cases, compared to mixed cases. In addition, presence of local recurrence was found to be statistically significantly associated with estrogen receptor (ER) status (p = 0.004), progesterone receptor (PR) status (p = 0.001), and c-erb-B2 overexpression (p = 0.016) in all patients. Overall survival rate was significantly associated with ER staining of the tumor (log-rank = 0.028). Our findings suggest that hormone receptor negativity may explain the more aggressive behavior of pure IMPC compared to mixed cases. Besides, longer survival period of patients with ER positivity, and the relationship of hormone status and c-erb-B2 overexpression and local recurrence further support favorable prognostic value of hormone receptors in invasive breast cancer.

Expression and significance of Hsp27 in invasive micropapillary carcinoma of the breast

Expression and significance of Hsp27 in invasive micropapillary carcinoma of the breast

Comparative mammary oncology: canine model.

Comparative mammary oncology: canine model.