Kim Hyun-Jung, Park Kyeongmee, Kim Jung Yeon, Kang Guhyun, Gwak Geumhee, Park Inseok
Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Korea.
Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.
J Pathol Transl Med. 2017 Jul;51(4):403-409. doi: 10.4132/jptm.2017.03.18. Epub 2017 Jun 9.
Mucinous carcinoma of the breast is an indolent tumors with a favorable prognosis; however, micropapillary features tend to lead to aggressive behavior. Thus, mucinous carcinoma and micropapillary carcinoma exhibit contrasting biologic behaviors. Here, we review invasive mucinous carcinoma with a focus on micropapillary features and correlations with clinicopathological factors.
A total of 64 patients with invasive breast cancer with mucinous or micropapillary features were enrolled in the study. Of 36 pure mucinous carcinomas, 17 (47.2%) had micropapillary features and were termed mucinous carcinoma with micropapillary features (MUMPC), and 19 (52.8%) had no micropapillary features and were termed mucinous carcinoma without micropapillary features. MUMPC were compared with 15 invasive micropapillary carcinomas (IMPC) and 13 invasive ductal and micropapillary carcinomas (IDMPC).
The clinicopathological factors of pure mucinous carcinoma and MUMPC were not significantly different. In contrast to IMPC and IDMPC, MUMPC had a low nuclear grade, lower mitotic rate, higher expression of hormone receptors, negative human epidermal growth factor receptor 2 (HER2) status, lower Ki-67 proliferating index, and less frequent lymph node metastasis (p < .05). According to univariate analyses, progesterone receptor, HER2, T-stage, and lymph node metastasis were significant risk factors for overall survival; however, only T-stage remained significant in a multivariate analysis (p < .05).
In contrast to IMPC and IDMPC, the micropapillary pattern in mucinous carcinoma does not contribute to aggressive behavior. However, further analysis of a larger series of patients is required to clarify the prognostic significance of micropapillary patterns in mucinous carcinoma of the breast.
乳腺黏液癌是一种预后良好的惰性肿瘤;然而,微乳头特征往往导致侵袭性行为。因此,黏液癌和微乳头癌表现出相反的生物学行为。在此,我们回顾侵袭性黏液癌,重点关注微乳头特征及其与临床病理因素的相关性。
本研究共纳入64例具有黏液或微乳头特征的侵袭性乳腺癌患者。在36例纯黏液癌中,17例(47.2%)具有微乳头特征,被称为具有微乳头特征的黏液癌(MUMPC),19例(52.8%)无微乳头特征,被称为无微乳头特征的黏液癌。将MUMPC与15例侵袭性微乳头癌(IMPC)和13例侵袭性导管和微乳头癌(IDMPC)进行比较。
纯黏液癌和MUMPC的临床病理因素无显著差异。与IMPC和IDMPC相比,MUMPC的核分级低、有丝分裂率低、激素受体表达高、人表皮生长因子受体2(HER2)状态为阴性、Ki-67增殖指数低且淋巴结转移频率低(p <.05)。单因素分析显示,孕激素受体、HER2、T分期和淋巴结转移是总生存的显著危险因素;然而,多因素分析中只有T分期仍然具有显著性(p <.05)。
与IMPC和IDMPC相比,黏液癌中的微乳头模式并不导致侵袭性行为。然而,需要对更多患者进行进一步分析,以阐明乳腺黏液癌中微乳头模式的预后意义。