Clinic of Radiation Oncology, Muğla Sıtkı Koçman University Hospital, Muğla, Turkey.
Clinic of Medical Oncology, MKA Breast Cancer Clinic, Ankara, Turkey.
Balkan Med J. 2022 Jul 22;39(4):275-281. doi: 10.4274/balkanmedj.galenos.2022.2022-4-7.
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.
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.
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.
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.
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).
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.
浸润性微乳头状癌（IMPC）是一种罕见的乳腺肿瘤。根据微乳头状分化的程度，IMPC 可分为纯型或混合型。
通过回顾性比较纯型和混合型 IMPC 患者的临床病理特征和临床结局，评估 IMPC 成分在乳腺癌中的预后意义。
回顾性分析 2000 年 1 月至 2022 年期间经病理组织学诊断为浸润性乳腺癌的 6648 例患者中 147 例（2.2%）IMPC 患者的数据。将患者分为两组：纯型 IMPC 和混合型 IMPC。
回顾分析患者的临床病理特征，如诊断时的年龄、组织学类型、分级、大小和混合癌成分、转移淋巴结数量、淋巴管血管侵犯、激素受体和肿瘤 Her-2 状态、T、N、M 分期以及生存率等。对纯型和混合型 IMPC 患者的临床病理特征、失败模式和生存率进行编码和比较。
45 例（30.6%）患者为纯型，102 例（69.4%）患者为混合型 IMPC。中位随访时间为 46 个月（3-178）。孕激素受体阳性率在纯型组明显低于混合型组（66.7%比 83.3%，p：0.024）。在纯型和混合型组中，5 年总生存率分别为 90%和 91%（p：0.839）；无进展生存率分别为 70%和 77%（p：0.537）；局部区域无复发生存率分别为 86%和 95%（p：0.043）；5 年远处无复发生存率分别为 88%和 83%（p：0.066），局部区域复发率分别为 10.3%和 2%（p：0.052）。
与混合型 IMPC 相比，纯型 IMPC 似乎具有更具侵袭性的行为，局部区域无复发生存率较低，局部区域复发较多。这可能是由于孕激素受体阳性率较低。
