Sui Xulei, Feng Peipei, Sun Xiaoyuan, Liang Peng, Liu Ying, Zhang Guowei
Department of Radiology, Yantaishan Hospital, Yantai City, 264001, People's Republic of China.
Department of Pathology, Yantaishan Hospital (East Courtyard), Yantai City, 264003, People's Republic of China.
Breast Cancer (Dove Med Press). 2024 Apr 25;16:245-252. doi: 10.2147/BCTT.S454065. eCollection 2024.
This study determined the digital mammography and ultrasonography imaging features of pure invasive micropapillary carcinoma of the breast (PIMPC) and the correlation with pathologic features.
Nineteen patients diagnosed with PIMPC at Yantaishan Hospital from October 2015 to February 2022 were included in the study group. Forty patients with breast masses diagnosed as nonspecific invasive ductal carcinoma of the breast (NIDC) from July to December 2021 were included in the control group. Digital mammography and ultrasonography features were compared between the two groups.
Patients with PIMPC had a younger age profile compared to patients with NIDC (=0.017). Moreover, PIMPC masses were smaller than NIDC masses (=0.040). Imaging features analysis revealed significant differences in age groups (<45 years: χ²=5.971, =0.044) and the presence of spiculations or the crab claw sign (χ²=8.583, =0.004) between patients with PIMPC and NIDC. However, there were no statistically significant differences in the presence of calcifications, blood flow grading, pathologic molecular subtypes between the study and control groups. The Ki-67 proliferative index (χ²=1.052, =0.389), vascular invasion (χ²=2.263, =0.197), and lymph node metastasis (χ²=1.968, =0.386) showed no significant differences between PIMPC and NIDC patients.
PIMPC imaging features show specificity, such as tiny breast masses, spiculated edges, or crab claw-like patterns, and malignant signs appeared when the lesion was <2 cm in diameter. PIMPC mainly occurs in middle-aged women 45-59 y of age. Patients with PIMPC and NIDC of the breast are frequently associated with lymph node metastases and greater than one-half of the cases (74%) were shown to have a Ki-67 index >30%, suggesting a significant risk of recurrence and metastasis. Early therapeutic care for these patients is crucial. These results warrant further validation with additional samples from several centers due to the limited single-center sample size in the current study.
本研究确定了乳腺纯浸润性微乳头癌（PIMPC）的数字乳腺摄影和超声成像特征及其与病理特征的相关性。
研究组纳入了2015年10月至2022年2月在烟台山医院诊断为PIMPC的19例患者。对照组纳入了2021年7月至12月诊断为非特异性乳腺浸润性导管癌（NIDC）的40例乳腺肿块患者。比较两组的数字乳腺摄影和超声特征。
与NIDC患者相比，PIMPC患者年龄更小（P=0.017）。此外，PIMPC肿块小于NIDC肿块（P=0.040）。影像学特征分析显示，PIMPC患者与NIDC患者在年龄组（<45岁：χ²=5.971，P=0.044）以及毛刺或蟹爪征的存在（χ²=8.583，P=0.004）方面存在显著差异。然而，研究组与对照组在钙化的存在、血流分级、病理分子亚型方面无统计学显著差异。PIMPC患者与NIDC患者的Ki-67增殖指数（χ²=1.052，P=0.389）、血管侵犯（χ²=2.263，P=0.197）和淋巴结转移（χ²=1.968，P=0.386）无显著差异。
PIMPC的影像学特征具有特异性，如乳腺微小肿块、边缘有毛刺或蟹爪样形态，且当病变直径<2 cm时出现恶性征象。PIMPC主要发生于45 - 59岁的中年女性。乳腺PIMPC和NIDC患者常伴有淋巴结转移，超过一半的病例（74%）Ki-67指数>30%，提示复发和转移风险显著。对这些患者进行早期治疗护理至关重要。由于本研究单中心样本量有限，这些结果有待多个中心的更多样本进一步验证。
