Verras Georgios-Ioannis, Mulita Francesk, Tchabashvili Levan, Grypari Ioanna-Maria, Sourouni Sofia, Panagodimou Evangelia, Argentou Maria-Ioanna
Department of Surgery, Breast Unit, General University Hospital of Patras, Greece.
Pathology Department, University Hospital of Patras, Greece.
Prz Menopauzalny. 2022 Mar;21(1):73-80. doi: 10.5114/pm.2022.113834. Epub 2022 Feb 21.
Invasive micropapillary carcinoma (IMPC) is a rare, distinct histological subtype of breast carcinoma. While micropapillary histological architecture is found in up to 2-8% of all breast cancers, pure micropapillary carcinoma is infrequent and comprises 0.9-2% of breast carcinomas. Invasive micropapillary carcinoma is emerging as an oncological and surgical challenge due to a plethora of characteristics that constitute this histological pattern - interestingly, both elusive and aggressive. We present the case of a woman presenting with IMPC, who was primarily treated with tumour and lymph node marking, followed by primary systemic therapy (PST), and consequent oncoplastic surgery with sentinel lymph node biopsy. Our case report outlines the importance of awareness of histological subtypes in breast cancer by focusing on a case report of IMPC. The breast surgeon must be aware of the lymphotropic behaviour of this subtype and the high prevalence of lymph node involvement in such patients, and therefore focus on rigorous axillary assessment. One must not forget that, despite having a more aggressive biological profile, IMPC has demonstrated no difference in survival when compared to other histological subtypes, and treatment should conform to international guidelines with an emphasis on nodal staging.
浸润性微乳头状癌(IMPC)是一种罕见的、独特的乳腺癌组织学亚型。虽然在所有乳腺癌中,微乳头状组织学结构的发生率高达2% - 8%,但纯微乳头状癌并不常见,仅占乳腺癌的0.9% - 2%。由于构成这种组织学模式的大量特征,浸润性微乳头状癌正成为肿瘤学和外科领域的一项挑战——有趣的是,它既难以捉摸又具有侵袭性。我们报告了一例患有IMPC的女性病例,该患者首先接受了肿瘤和淋巴结标记,随后接受了一线全身治疗(PST),并进行了保乳手术及前哨淋巴结活检。我们的病例报告通过聚焦IMPC的病例报告,概述了认识乳腺癌组织学亚型的重要性。乳腺外科医生必须了解该亚型的亲淋巴行为以及此类患者淋巴结受累的高发生率,因此应着重进行严格的腋窝评估。必须牢记,尽管IMPC具有更具侵袭性的生物学特征,但与其他组织学亚型相比,其生存率并无差异,治疗应遵循国际指南,重点是淋巴结分期。