Kuroda Hajime, Sakamoto Goi, Ohnisi Kiyoshi, Itoyama Shinji
Department of Pathology, Saitama Medical Center, Saitama Medical School, 1981, Tsujido, Kamoda, Kawagoe, Saitama 350-8550, Japan.
Breast Cancer. 2004;11(2):169-74. doi: 10.1007/BF02968297.
Invasive micropapillary carcinoma(IMC)of the breast is a rare subtype of breast carcinoma that has an extremely high incidence of lymph node metastases and poor clinical outcome. This histological subtype of breast carcinoma has remained unclear due to the rarity of cases. Many questions exist on the clinicopathological significance of this subtype, especially regarding prognosis.
We reviewed all 671 cases of primary breast carcinoma that were surgically resected at our institute between 1990 and 2004. Of these, 27 cases of invasive ductal carcinoma of the breast with a pure or partial micropapillary component were reported. The cases were analyzed using various parameters, including age at presentation, tumor size, tumor grade, presence of lymphatic invasion, and axially lymph node status.
The patients' age at presentation ranged from 31 to 74 years (mean 52.4 years). Tumor size ranged from 0.7 to 10 cm (mean 4 cm). 88.9% (24 of 27) of the cases had lymphatic invasion. Of cases who underwent with axillary dissection, 66.6% (18 of 27) had positive lymph nodes. Clinical follow up data were available for 17 cases with IMC for 1 to 72 months. Among these, 10 patients died from breast carcinoma within 5 years.
While our series is too small to make conclusions about the behavior of IMC, the difference in 6-year survival rate between the patients with IMC and those with breast carcinoma in general was statistically significant. Recognition of this distinctive and aggressive variant of infiltrating carcinoma is important because of its poor prognosis and high incidence of lymph node metastases.
乳腺浸润性微乳头状癌（IMC）是一种罕见的乳腺癌亚型，淋巴结转移发生率极高，临床预后较差。由于病例罕见，这种乳腺癌的组织学亚型仍不清楚。关于该亚型的临床病理意义存在许多问题，尤其是在预后方面。
我们回顾了1990年至2004年间在我院手术切除的所有671例原发性乳腺癌病例。其中，报告了27例具有纯微乳头成分或部分微乳头成分的乳腺浸润性导管癌病例。使用各种参数对这些病例进行分析，包括就诊年龄、肿瘤大小、肿瘤分级、淋巴管浸润情况以及腋窝淋巴结状态。
患者就诊年龄在31岁至74岁之间（平均52.4岁）。肿瘤大小在0.7厘米至10厘米之间（平均4厘米）。其中88.9%（27例中的24例）有淋巴管浸润。在接受腋窝清扫术的病例中，66.6%（27例中的18例）有阳性淋巴结。有17例IMC患者有1至72个月的临床随访数据。其中，10例患者在5年内死于乳腺癌。
虽然我们的病例系列规模太小，无法就IMC的行为得出结论，但IMC患者与一般乳腺癌患者的6年生存率差异具有统计学意义。认识到这种独特且侵袭性的浸润性癌变体很重要，因为其预后较差且淋巴结转移发生率高。
