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Han Y, Li W, zhi R, Ma G, Gao A, Wu K, Sun H, Zhao D, Yang Y, Liu F, Gu F, Guo X, Dong J, Li S, Fu L. MiR-30c suppresses the proliferation, metastasis and polarity reversal of tumor cell clusters by targeting MTDH in invasive micropapillary carcinoma of the breast. Heliyon 2024; 10:e33938. [PMID: 39071710 PMCID: PMC11279262 DOI: 10.1016/j.heliyon.2024.e33938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/30/2024] [Accepted: 07/01/2024] [Indexed: 07/30/2024] Open
Abstract
Purpose Invasive micropapillary carcinoma (IMPC) of the breast has a high propensity for lymphovascular invasion and axillary lymph node metastasis and displays an 'inside-out' growth pattern, but the molecular mechanism of invasion, metastasis and cell polarity reversal in IMPC is unclear. Methods and Patients: Cell growth curves, tumor sphere formation assays, transwell assays, mouse xenograft model and immunofluorescence were evaluated to investigate the effects of miR-30c and MTDH. Dual luciferase reporter assays was performed to confirm that the MTDH (metadherin) 3'UTR bound to miR-30c. MiRNA in situ hybridization (ISH) and immunohistochemistry (IHC) were carried out on IMPC patient tissues for miR-30c and MTDH expression, respectively. Results We found miR-30c as a tumor suppressor gene in cell proliferation, metastasis and polarity reversal of IMPC. Overexpression of miR-30c inhibited cell growth and metastasis in vitro and in vivo. MiR-30c could directly target the MTDH 3'UTR. MiR-30c overexpression inhibited breast cancer cell proliferation, invasion and metastasis by targeting MTDH. Moreover, miR-30c/MTDH axis could also regulate cell polarity reversal of IMPC. By ISH and IHC analyses, miR-30c and MTDH were significantly correlated with tumor size, lymph nodule status and tumor grade, the 'inside-out' growth pattern, overall survival (OS) and disease-free survival (DFS) in IMPC patients. Conclusions Overall, miR-30c/MTDH axis was responsible for tumor proliferation, metastasis and polarity reversal. It may provide promising therapeutic targets and prognostic biomarkers for patients with IMPC.
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Affiliation(s)
- Yunwei Han
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Weidong Li
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Renyong zhi
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Gui Ma
- Department of Genetics and Cell Biology, College of Life Sciences, Nankai University, 94 Weijin Road, Tianjin 300071, China
- Southern University of Science and Technology, School of Medicine, 1088 Xueyuan Road, Shenzhen, Guangdong 518055, China
- Emory Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University School of Medicine, 1365C Clifton Road, Atlanta, 30322, Georgia, USA
| | - Ang Gao
- Department of Genetics and Cell Biology, College of Life Sciences, Nankai University, 94 Weijin Road, Tianjin 300071, China
- Southern University of Science and Technology, School of Medicine, 1088 Xueyuan Road, Shenzhen, Guangdong 518055, China
- Emory Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University School of Medicine, 1365C Clifton Road, Atlanta, 30322, Georgia, USA
| | - Kailiang Wu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Hui Sun
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Dan Zhao
- Department of Genetics and Cell Biology, College of Life Sciences, Nankai University, 94 Weijin Road, Tianjin 300071, China
- Southern University of Science and Technology, School of Medicine, 1088 Xueyuan Road, Shenzhen, Guangdong 518055, China
- Emory Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University School of Medicine, 1365C Clifton Road, Atlanta, 30322, Georgia, USA
| | - Yiling Yang
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Fangfang Liu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Feng Gu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Xiaojing Guo
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Jintang Dong
- Department of Genetics and Cell Biology, College of Life Sciences, Nankai University, 94 Weijin Road, Tianjin 300071, China
- Southern University of Science and Technology, School of Medicine, 1088 Xueyuan Road, Shenzhen, Guangdong 518055, China
- Emory Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University School of Medicine, 1365C Clifton Road, Atlanta, 30322, Georgia, USA
| | - Shuai Li
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Li Fu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- National Clinical Research Center of Cancer, Tianjin 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China
- Ministry of Education, Breast Cancer Innovation Team of the Ministry of Education, Tianjin 300060, China
- Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
- Gene Editing Center, School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
- Shanghai Institute for Advanced Immunochemical Studies, ShanghaiTech University, Shanghai 201210, China
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Magnoni F, Bianchi B, Pagan E, Corso G, Sala I, Bagnardi V, Claudia S, Brancaccio R, Bottazzoli E, Boato A, Munzone E, Dellapasqua S, Fusco N, Viviana G, Veronesi P. Long-term outcome of invasive pure micropapillary breast cancer compared with invasive mixed micropapillary and invasive ductal breast cancer: a matched retrospective study. Breast Cancer Res Treat 2024:10.1007/s10549-024-07422-7. [PMID: 38963526 DOI: 10.1007/s10549-024-07422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE Data on the prognostic impact of the micropapillary component in breast cancer are limited. The purpose of this study was to investigate the clinicopathological characteristics and long-term outcomes of pure and mixed invasive micropapillary breast cancer (IMPC) patients compared to invasive ductal cancer (IDC) patients. METHODS This retrospective study analysed all IMPC and IDC patients treated at the European Institute of Oncology (IEO) between 1997 and 2019. The overall cohort of IMPC patients was divided in two groups, pure and mixed IMPC. Each patient with mixed or pure IMPC was matched with one patient with IDC, based on year of surgery, age, pT, pN, and molecular subtype. RESULTS A total of 30,115 IDC, 120 pure IMPC and 150 mixed IMPC patients were considered eligible. Compared to IDC, pure and mixed IMPC patients presented a higher rate of locally advanced disease (pT2-T3, pN2-N3), vascular invasion, and Luminal B subtype. After matching, pure and mixed IMPC showed a significant higher rate of vascular invasion compared to IDC patients (p < 0.001). Invasive disease-free survival was better in IDC compared to pure IMPC patients (p = 0.11). Long-term overall survival was significantly worse in pure IMPC group compared to IDC group (p = 0.004), being instead similar between mixed IMPC vs matched IDC (p = 0.07). CONCLUSION These real-world data reported the worse prognosis of pure IMPC compared to IDC, highlighting the peculiar prognostic value of the micropapillary subtype itself in the decision-making process of IMPC management. An accurate pre-surgical diagnostic evaluation and a multidisciplinary approach are pivotal to best personalize its treatment.
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Affiliation(s)
- Francesca Magnoni
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy.
| | - Beatrice Bianchi
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Giovanni Corso
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hematology, University of Milano, Milan, Italy
| | - Isabella Sala
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Sangalli Claudia
- Data Management, European Institute of Oncology, IRCCS, Milan, Italy
| | - Roberta Brancaccio
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Elisa Bottazzoli
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Antony Boato
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Elisabetta Munzone
- Division of Medical Senology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Silvia Dellapasqua
- Division of Medical Senology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Nicola Fusco
- Department of Oncology and Hematology, University of Milano, Milan, Italy
- Division of Pathology, European Institute of Oncology, IRCCS, 20141, Milan, Italy
| | - Galimberti Viviana
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Paolo Veronesi
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hematology, University of Milano, Milan, Italy
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Oz O, Irmak Yuzuguldu R, Yazici A, Kocatepe Cavdar D, Yilmaz C, Ozturk M, Duzel H, Gurel D. The differences between pure and mixed invasive micropapillary breast cancer: the epithelial-mesenchymal transition molecules and prognosis. Breast Cancer Res Treat 2024:10.1007/s10549-024-07384-w. [PMID: 38955980 DOI: 10.1007/s10549-024-07384-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 05/19/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Invasive micropapillary carcinoma (IMPC) of the breast is known for its high metastatic potential, but the definition of pure and mixed IMPC remains unclear. This retrospective cohort study aims to investigate the prognostic significance of the micropapillary component ratio and the expression of critical molecules of epithelial-mesenchymal transition (EMT), including E-cadherin (E-cad), N-cadherin (N-cad), CD44s, and β-catenin (β-cat), in distinguishing between pure and mixed IMPCs. METHODS We analyzed 100 cases of locally advanced IMPC between 2000 and 2018 and excluded patients who received neoadjuvant chemotherapy. Pure IMPC was defined as having a micropapillary component of over 90%. A comprehensive recording of prognostic parameters was conducted. The IMPC areas were analyzed using the immunohistochemical (IHC) staining method on the microarray set for pure and mixed IMPC patients. Pearson's chi-square, Fisher's exact tests, Kaplan-Meier analysis, and Cox proportional hazards analysis were employed. RESULTS The comparative survival analysis of the entire group, based on overall survival (OS) and disease-free survival (DFS), revealed no significant difference between the pure and mixed groups (P = 0.480, HR = 1.474 [0.502-4.325] and P = 0.390, HR = 1.587 [0.550-4.640], respectively). However, in the pure IMPC group, certain factors were found to be associated with a higher risk of short survival. These factors included skin involvement (P = 0.050), pT3&4 category (P = 0.006), a ratio of intraductal component (> 5%) (P = 0.032), and high-level expression of N-cad (P = 0.020). Notably, none of the risk factors identified for short OS in pure IMPC cases were observed as significant risks in mixed cases and vice versa. Furthermore, N-cad was identified as a poor prognostic marker for OS in pure IMPCs (P = 0.002). CONCLUSION The selection of a 90% ratio for classifying pure IMPCs revealed significant differences in certain molecular and prognostic parameters between pure and mixed groups. Notably, the involvement of N-cadherin in the epithelial-mesenchymal transition (EMT) process provided crucial insights for predicting OS and DFS while also distinguishing between the two groups. These findings strongly support the notion that the pure IMPC subgroup represents a distinct entity characterized by unique molecular characteristics and behavioral patterns.
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Affiliation(s)
- Ozden Oz
- Department of Pathology, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey.
| | | | - Ayse Yazici
- Department of Pathology, Faculty of Medicine, Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Demet Kocatepe Cavdar
- Department of Pathology, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Cengiz Yilmaz
- Department of Medical Oncology, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Mucteba Ozturk
- Department of General Surgery, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Hilal Duzel
- Department of Public Health, Medical Faculty, Dokuz Eylul University, Izmir, Turkey
| | - Duygu Gurel
- Department of Pathology, Medical Faculty, Dokuz Eylul University, Izmir, Turkey
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Dnyanmote A, M P H. Unusual Case of Papillary Carcinoma of the Breast. Cureus 2024; 16:e63568. [PMID: 39087193 PMCID: PMC11289855 DOI: 10.7759/cureus.63568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Papillary carcinoma of the breast represents a distinct subtype of breast cancer characterized by its unique clinical and histopathological features. It is seen predominantly affecting post-menopausal women. Overall, papillary carcinoma has a low prevalence. Histologically, papillary carcinoma is characterized by the presence of papillae-like structures lined by epithelial cells and supported by fibrovascular cores, appearing like a dual-layered epithelium. The clinical, epidemiological, and pathological characteristics of papillary carcinoma of the breast are not widely described in the existing literature. The gold standard for diagnosis of carcinoma breast of any type remains a core needle biopsy, but in our case, the diagnosis of papillary carcinoma was made in the final histopathology specimen. Treatment strategies for papillary carcinoma include surgical excision with or without axillary dissection followed by adjuvant chemo-radiotherapy depending on the immunohistochemistry and tumor characteristics, but there appear multiple variations in the management of more common NOS (not otherwise specified) type and the papillary carcinoma of the breast. We present a case report of this papillary carcinoma of the breast.
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Affiliation(s)
- Anuradha Dnyanmote
- Department of General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Himashree M P
- Department of General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
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Qian F, Shen H, Deng C, Liu C, Su T, Chen A, Hu D, Zhu J. Establishment of a logistic regression model nomogram for clinicopathological characteristics and risk factors with axillary lymph node metastasis in T1 locally advanced breast cancer: a retrospective study. Gland Surg 2024; 13:871-884. [PMID: 39015720 PMCID: PMC11247567 DOI: 10.21037/gs-24-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/29/2024] [Indexed: 07/18/2024]
Abstract
Background Although the research reports on locally advanced breast cancer (LABC) are increasing year by year, there are few reports on T1 LABC axillary lymph node metastasis (ALNM). By establishing a prediction model for T1 LABC ALNM, this study provides a reference value for the probability of ALNM of related patients, which helps clinicians to develop a more effective and individualized treatment plan for LABC. Methods Cases with pathologically confirmed T1 breast cancer (BC) between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were identified. Logistic regression was used to analyze the correlation between LABC lymph node metastasis and every factor, and the odds ratio (OR) and 95% confidence interval (CI) were used to identify any influencing factors. A nomogram was drawn after incorporating meaningful factors identified in multivariate logistic regression into the model. The receiver operating characteristic (ROC) curve of the model was drawn, and the area under the curve (AUC) and its 95% CI were calculated. Hosmer-Lemeshow goodness-of-fit test and clinical decision curve analysis (DCA) were performed. The results were validated in the validation group. Results A total of 200,933 female T1 BC patients were included in this study. Univariate and multivariate logistic regression analysis of T1 BC showed that progesterone receptor (PR)-negative, race, age, lobular carcinoma, micropapillary ductal carcinoma, axillary tail tumor, poor differentiation, and larger tumor diameter increased the probability of ALNM in T1 LABC. A predictive nomogram was established using the above predictors, the AUC of the modeling group was 0.739 (95% CI: 0.732-0.747), and when the AUC cut-off value was 0.026, the specificity and sensitivity of the model were 65.78% and 69.99%, respectively. Validation of the model showed that the AUC of the validation group (n=60,280) was 0.741. When all the risk factors were met, the predicted probability of N2-N3 was 50.40%. Conclusions In this study, it was found that PR-negative, Black race, age, lobular carcinoma, micropapillary ductal carcinoma, axillary tail tumor, poor differentiation, and tumor diameter increased the probability of large lymph node metastasis in T1 LABC small tumors.
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Affiliation(s)
- Fang Qian
- Postgraduate Training Base of the Xiaogan Central Hospital of Jinzhou Medical University, Xiaogan, China
| | - Haoyuan Shen
- Department of Thyroid Gland Breast Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology (Xiaogan Central Hospital), Xiaogan, China
| | - Chunyan Deng
- Department of Pediatrics, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology (Xiaogan Central Hospital), Xiaogan, China
| | - Chenghao Liu
- Department of Thyroid Gland Breast Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology (Xiaogan Central Hospital), Xiaogan, China
| | - Tingting Su
- Department of Thyroid Gland Breast Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology (Xiaogan Central Hospital), Xiaogan, China
| | - Anli Chen
- Postgraduate Training Base of the Xiaogan Central Hospital of Jinzhou Medical University, Xiaogan, China
| | - Di Hu
- Department of Thyroid Gland Breast Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology (Xiaogan Central Hospital), Xiaogan, China
| | - Jiacheng Zhu
- Department of Thyroid Gland Breast Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology (Xiaogan Central Hospital), Xiaogan, China
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Oz O, Tasli FA, Yuzuguldu RI, Zengel B, Cavdar DK, Durak MG, Durusoy R. Comprehensive Immunohistochemical Analysis of Epithelial-Mesenchymal Transition Biomarkers in the Invasive Micropapillary Cancer of the Breast. Int J Breast Cancer 2024; 2024:2350073. [PMID: 38903413 PMCID: PMC11189676 DOI: 10.1155/2024/2350073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/13/2024] [Accepted: 03/30/2024] [Indexed: 06/22/2024] Open
Abstract
Background: Invasive micropapillary carcinoma (IMPC) of the breast is commonly associated with a poor prognosis due to its high incidence of lymphovascular invasion and lymph node metastasis (LNM). Our study is aimed at investigating the prognostic significance of the expressions of E-cadherin (E-cad), N-cadherin (N-cad), CD44s, and β-catenin (β-cat). In addition, it is aimed at deciphering the consistency of these markers between the IMPC, the invasive breast carcinoma, no-special type (IBC-NST), and LNM components in the same IMPC cases. Methods: Sixty-two IMPC cases with LNM from 1996 to 2018 were analyzed. Immunohistochemical staining was performed separately on the three regions for each patient. Statistical analyses included Kaplan-Meier, Cox regression, and McNemar's statistical tests. Results: Loss of CD44 expression in IMPC, IBC-NST, and LNM areas was associated with poor prognosis in overall survival (OS) (p = 0.010, p < 0.0005, p = 0.025). Loss of CD44 expression in the IBC-NST, gain of N-cad expression in the IMPC, and loss of β-cat expression in the LNM areas were indicators of poor prognosis in disease-free survival (DFS) (p = 0.005, p = 0.041, p = 0.009). Conclusion: Our evaluation of this rare subtype, focusing on the expression of key epithelial-mesenchymal transition (EMT) molecules, revealed that it shares characteristics with the IBC-NST component within mixed tumors. Notably, contrary to expectations, a reduction in CD44 expression was found to adversely affect both OS and DFS. By conducting staining procedures simultaneously across three regions within the same patient, a novel approach has provided valuable insights into the mechanisms of EMT.
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Affiliation(s)
- Ozden Oz
- Izmir Bozyaka Training and Research HospitalDepartment of PathologyUniversity of Health Sciences, Izmir, Türkiye
| | - Funda Alkan Tasli
- Izmir Bozyaka Training and Research HospitalDepartment of PathologyUniversity of Health Sciences, Izmir, Türkiye
| | - Resmiye Irmak Yuzuguldu
- Faculty of MedicineTraining and Research HospitalDepartments of PathologyMugla Sıtkı Koçman University, Mugla, Türkiye
| | - Baha Zengel
- Izmir Bozyaka Training and Research HospitalDepartment of PathologyUniversity of Health Sciences, Izmir, Türkiye
| | - Demet Kocatepe Cavdar
- Izmir Bozyaka Training and Research HospitalDepartment of PathologyUniversity of Health Sciences, Izmir, Türkiye
| | - Merih Guray Durak
- Medical FacultyDepartments of PathologyDokuz Eylul University, Izmir, Türkiye
| | - Raika Durusoy
- Department of Public HealthMedical FacultyEge University, Izmir, Türkiye
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7
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Meng X, Hao F, Wang N, Qin P, Ju Z, Sun D. Log odds of positive lymph nodes (LODDS)-based novel nomogram for survival estimation in patients with invasive micropapillary carcinoma of the breast. BMC Med Res Methodol 2024; 24:90. [PMID: 38637725 PMCID: PMC11025266 DOI: 10.1186/s12874-024-02218-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/15/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Invasive micropapillary carcinoma (IMPC) of the breast is known for its high propensity for lymph node (LN) invasion. Inadequate LN dissection may compromise the precision of prognostic assessments. This study introduces a log odds of positive lymph nodes (LODDS) method to address this issue and develops a novel LODDS-based nomogram to provide accurate prognostic information. METHODS The study analyzed data from 1,901 patients with breast IMPC from the Surveillance, Epidemiology, and End Results database. It assessed the relationships between LODDS and the number of excised LN (eLN), positive LN (pLN), and the pLN ratio (pLNR), identifying an optimal threshold value using a restricted cubic spline method. Predictive factors were identified by the Cox least absolute shrinkage and selection operator (Cox-LASSO) regression and validated through multivariate Cox regression to construct a nomogram. The model's accuracy, discrimination, and utility were assessed. The study also explored the consequences of excluding LODDS from the nomogram and compared its effectiveness with the tumor-node-metastasis (TNM) staging system. RESULTS LODDS improved N status classification by identifying heterogeneity in patients with pLN ratios of 0% (pLN =0) or 100% (pLN =eLN) and setting -1.08 as the ideal cutoff. Five independent prognostic factors for breast cancer-specific survival (BCSS) were identified: tumor size, N status, LODDS, progesterone receptor status, and histological grade. The LODDS-based nomogram achieved a strong concordance index of 0.802 (95% CI: 0.741-0.863), surpassing both the version without LODDS and the conventional TNM staging in all tests. CONCLUSIONS For breast IMPC, LODDS served as an independent prognostic factor, its effectiveness unaffected by the anatomical LN count, enhancing the accuracy of N staging. The LODDS-based nomogram showed promise in offering more personalized prognostic information.
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Affiliation(s)
- Xiangdi Meng
- Department of Radiation Oncology, Weifang People's Hospital, No. 151 Guangwen Street, Kuiwen District, Weifang, 261041, Shandong, China
- Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Furong Hao
- Department of Radiation Oncology, Weifang People's Hospital, No. 151 Guangwen Street, Kuiwen District, Weifang, 261041, Shandong, China
| | - Nan Wang
- Department of Radiation Oncology, Weifang People's Hospital, No. 151 Guangwen Street, Kuiwen District, Weifang, 261041, Shandong, China
| | - Peiyan Qin
- Department of Radiation Oncology, Weifang People's Hospital, No. 151 Guangwen Street, Kuiwen District, Weifang, 261041, Shandong, China
| | - Zhuojun Ju
- Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Daqing Sun
- Department of Radiation Oncology, Weifang People's Hospital, No. 151 Guangwen Street, Kuiwen District, Weifang, 261041, Shandong, China.
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Li Y, Liu J, Xu Z, Shang J, Wu S, Zhang M, Liu Y. Construction and validation of a nomogram for predicting the prognosis of patients with lymph node-positive invasive micropapillary carcinoma of the breast: based on SEER database and external validation cohort. Front Oncol 2023; 13:1231302. [PMID: 37954073 PMCID: PMC10635422 DOI: 10.3389/fonc.2023.1231302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Background Invasive micropapillary carcinoma (IMPC) of the breast is a rare subtype of breast cancer with high incidence of aggressive clinical behavior, lymph node metastasis (LNM) and poor prognosis. In the present study, using the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed the clinicopathological characteristics and prognostic factors of IMPC with LNM, and constructed a prognostic nomogram. Methods We retrospectively analyzed data for 487 breast IMPC patients with LNM in the SEER database from January 2010 to December 2015, and randomly divided these patients into a training cohort (70%) and an internal validation cohort (30%) for the construction and internal validation of the nomogram, respectively. In addition, 248 patients diagnosed with IMPC and LNM at the Fourth Hospital of Hebei Medical University from January 2010 to December 2019 were collected as an external validation cohort. Lasso regression, along with Cox regression, was used to screen risk factors. Further more, the discrimination, calibration, and clinical utility of the nomogram were assessed based on the consistency index (C-index), time-dependent receiver operating characteristic (ROC), calibration curve, and decision curve analysis (DCA). Results In summary, we identified six variables including molecular subtype of breast cancer, first malignant primary indicator, tumor grade, AJCC stage, radiotherapy and chemotherapy were independent prognostic factors in predicting the prognosis of IMPC patients with LNM (P < 0.05). Based on these factors, a nomogram was constructed for predicting 3- and 5-year overall survival (OS) of patients. The nomogram achieved a C-index of 0.789 (95%CI: 0.759-0.819) in the training cohort, 0.775 (95%CI: 0.731-0.819) in the internal validation cohort, and 0.788 (95%CI: 0.756-0.820) in the external validation cohort. According to the calculated patient risk score, the patients were divided into a high-risk group and a low-risk group, which showed a significant difference in the survival prognosis of the two groups (P<0.0001). The time-dependent ROC curves, calibration curves and DCA curves proved the superiority of the nomogram. Conclusions We have successfully constructed a nomogram that could predict 3- and 5-year OS of IMPC patients with LNM and may assist clinicians in decision-making and personalized treatment planning.
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Affiliation(s)
- Yifei Li
- Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jinzhao Liu
- The Second Department of Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou, China
| | - Zihang Xu
- College of Basic Medical Sciences, Hebei Medical University, Shijiazhuang, China
| | - Jiuyan Shang
- Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Si Wu
- Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng Zhang
- Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yueping Liu
- Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Chen E, Du Y, Chen Y, Gan Y, Gao H, Hu X, Li Q, Zhang X. A web-based novel model for predicting prognostic value in patients with invasive micropapillary carcinoma in breast cancer: a real-world data retrospective cohort study. Updates Surg 2023; 75:1997-2004. [PMID: 37222906 DOI: 10.1007/s13304-023-01530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023]
Abstract
Invasive micropapillary carcinoma (IMPC) accounts for less than 2% of all invasive breast cancers and usually associates with poor survival, so we investigated the prognostic factors for IMPC using a large population-based database and designed a web-based novel model. Clinicopathological prognostic factors were evaluated using the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox regression analysis was performed to evaluate the prognostic value of variables on the overall survival. A web-based nomogram was finally constructed to predict the survival probability. The model was validated in an external dataset. A web-based model, combined with age, radiation, clinical stage, and hormone receptor (HR) immunochemistry status four prognostic factors, was constructed. The C-index (0.714, 95% CI 0.683-0.741), calibration curves, and decision curves showed that this model was superior in prediction. By determining the cut-off values, high-risk group and low-risk group were divided. The Kaplan-Meier survival curves showed that these two groups had significantly different survival rates (P < 0.0001). The result of C-index, calibration curves, and Kaplan-Meier survival curves were consistent in the validation cohort. The novel nomogram with four risk factors resulted in accurate prognostic prediction for IMPC.
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Affiliation(s)
- Endong Chen
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuan Du
- The 1St School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yingying Chen
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yaowei Gan
- The 1St School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haoze Gao
- The 1St School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoqu Hu
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Quan Li
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Xiaohua Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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10
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Wu K, Li W, Liu H, Niu C, Shi Q, Zhang J, Gao G, Sun H, Liu F, Fu L. Metabolome Sequencing Reveals that Protein Arginine-N-Methyltransferase 1 Promotes the Progression of Invasive Micropapillary Carcinoma of the Breast and Predicts a Poor Prognosis. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:1267-1283. [PMID: 37301537 DOI: 10.1016/j.ajpath.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/28/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
Invasive micropapillary carcinoma (IMPC) of the breast is a special histopathologic type of cancer with a high recurrence rate and the biological features of invasion and metastasis. Previous spatial transcriptome studies indicated extensive metabolic reprogramming in IMPC, which contributes to tumor cell heterogeneity. However, the impact of metabolome alterations on IMPC biological behavior is unclear. Herein, endogenous metabolite-targeted metabolomic analysis was done on frozen tumor tissue samples from 25 patients with breast IMPC and 34 patients with invasive ductal carcinoma not otherwise specified (IDC-NOS) by liquid chromatography-mass spectrometry. An IMPC-like state, which is an intermediate transitional morphologic phenotype between IMPC and IDC-NOS, was observed. The metabolic type of IMPC and IDC-NOS was related to breast cancer molecular type. Arginine methylation modification and 4-hydroxy-phenylpyruvate metabolic changes play a major role in the metabolic reprogramming of IMPC. High protein arginine-N-methyltransferase (PRMT) 1 expression was an independent factor related to the poor prognosis of patients with IMPC in terms of disease-free survival. PRMT1 promoted H4R3me2a, which induced tumor cell proliferation via cell cycle regulation and facilitated tumor cell metastasis via the tumor necrosis factor signaling pathway. This study identified the metabolic type-related features and intermediate transition morphology of IMPC. The identification of potential targets of PRMT1 has the potential to provide a basis for the precise diagnosis and treatment of breast IMPC.
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Affiliation(s)
- Kailiang Wu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China; Department of Clinical Laboratory, Tianjin Medical University General Hospital, Tianjin, China
| | - Weidong Li
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Hanjiao Liu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Chen Niu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Qianqian Shi
- Department of Laboratory Medicine, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingyue Zhang
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Guangshen Gao
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Hui Sun
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Fangfang Liu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
| | - Li Fu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
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11
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Cheng Y, Zhang P, Huang Y, Zhang Z, Tang R, Chi F, Sun JY, He Z. Development and validation of nomograms to predict survival in patients with invasive micropapillary carcinoma of the breast. BMJ Open 2023; 13:e065312. [PMID: 36810178 PMCID: PMC9944677 DOI: 10.1136/bmjopen-2022-065312] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVES The present study aimed to develop and validate nomograms to predict the survival of patients with breast invasive micropapillary carcinoma (IMPC) to aid objective decision-making. DESIGN Prognostic factors were identified using Cox proportional hazards regression analyses and used to construct nomograms to predict overall survival (OS) and breast cancer-specific survival (BCSS) at 3 and 5 years. Kaplan-Meier analysis, calibration curves, the area under the curve (AUC) and the concordance index (C-index) evaluated the nomograms' performance. Decision curve analysis (DCA), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to compare the nomograms with the American Joint Committee on Cancer (AJCC) staging system. SETTING Patient data were collected from the Surveillance, Epidemiology, and End Results (SEER) database. This database holds data related to the incidence of cancer acquired from 18 population-based cancer registries in the US. PARTICIPANTS We ruled out 1893 patients and allowed the incorporation of 1340 patients into the present study. RESULTS The C-index of the AJCC8 stage was lower than that of the OS nomogram (0.670 vs 0.766) and the OS nomograms had higher AUCs than the AJCC8 stage (3 years: 0.839 vs 0.735, 5 years: 0.787 vs 0.658). On calibration plots, the predicted and actual outcomes agreed well, and DCA revealed that the nomograms had better clinical utility compared with the conventional prognosis tool. In the training cohort, the NRI for OS was 0.227, and for BCSS was 0.182, while the IDI for OS was 0.070, and for BCSS was 0.078 (both p<0.001), confirming its accuracy. The Kaplan-Meier curves for nomogram-based risk stratification showed significant differences (p<0.001). CONCLUSIONS The nomograms showed excellent discrimination and clinical utility to predict OS and BCSS at 3 and 5 years, and could identify high-risk patients, thus providing IMPC patients with personalised treatment strategies.
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Affiliation(s)
- Yixin Cheng
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Pengkun Zhang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yulin Huang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhihui Zhang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ru Tang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Feng Chi
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jia-Yuan Sun
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhenyu He
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong, China
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12
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Zhao Y, Li S, Yan L, Yang Z, Chai N, Qiu P, Zhang J, Zhang H, He J, Zhou C. Nomogram for predicting overall survival in patients with invasive micropapillary carcinoma after breast-conserving surgery: A population-based analysis. Front Surg 2022; 9:1009149. [PMID: 36338630 PMCID: PMC9634413 DOI: 10.3389/fsurg.2022.1009149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/28/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Due to the loss of prediction of overall survival (OS) for patients with invasive micropapillary carcinoma (IMPC) after breast-conserving surgery (BCS), this study aimed to construct a nomogram for predicting OS in IMPC patients after BCS. METHODS In total, 481 eligible cases staged 0-III IMPC from 2000 to 2016 were retrieved from the SEER database. A nomogram was built based on the variables selected by LASSO regression to predict the 3-year and 5-year probabilities of OS. RESULTS A total of 336 patients were randomly assigned to the training cohort and 145 cases in the validation cohort. The LASSO regression revealed that six variables (age at diagnosis, AJCC stage, marital status, ER status, PR status, and chemotherapy) were predictive variables of OS, and then a nomogram model and an easy-to-use online tool were constructed. The C-indices 0.771 in the training cohort and 0.715 in the validation cohort suggested the robustness of the model. The AUC values for 3-year and 5-year OS in the training cohort were 0.782, 0.790, and 0.674, and 0.682 in the validation cohort, respectively. Based on the cutoff values of 147.23 and 222.44 scores calculated by X-tile analysis, participants in the low-risk group (≤147.23 scores) had a more favorable OS in comparison with those in the medium (>147.23, but <222.44 scores)- and high-risk groups (≥222.44 scores). CONCLUSIONS By risk stratification, this model is expected to provide a precise and personalized prediction of the cumulative risk and guide treatment decision-making in improving OS strategies for IMPC patients.
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Affiliation(s)
- Yuting Zhao
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Shouyu Li
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Lutong Yan
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Zejian Yang
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Na Chai
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Pei Qiu
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Jian Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Huimin Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jianjun He
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,Correspondence: Jianjun He Can Zhou
| | - Can Zhou
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China,Correspondence: Jianjun He Can Zhou
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Dolezal D, Zhang X, Harigopal M. Increased Expression of LEF1 and β-Catenin in Invasive Micropapillary Carcinoma of the Breast is Associated With Lymphovascular Invasion and Lymph Node Metastasis. Appl Immunohistochem Mol Morphol 2022; 30:557-565. [PMID: 35960138 DOI: 10.1097/pai.0000000000001052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/09/2022] [Indexed: 11/26/2022]
Abstract
Invasive micropapillary breast carcinoma (IMPC) is a rare breast cancer subtype characterized by small tumor cell clusters with loss of stromal attachment, an inside-out growth appearance, and lymphotropism. IMPC is associated with high incidence of lymphovascular invasion (LVI) and lymph node metastasis. Activated Wnt signaling has been implicated in the metastasis of other aggressive breast tumors, including triple-negative and basal-like carcinomas. In this study, we tested whether activated Wnt signaling could be detected in IMPC. Upon ligand binding, the central mediator of the Wnt pathway, β-catenin, accumulates in the cytosol and translocates to the nucleus where it forms a complex with lymphoid enhancer-binding factor 1 (LEF1) to regulate transcription. We performed immunostaining for β-catenin and LEF1 on a well-annotated cohort of 40 breast tumors and nodal metastases displaying micropapillary histopathology. Strong nuclear accumulation of β-catenin was not observed, however a dim cytosolic and/or nuclear accumulation of β-catenin was sometimes seen in IMPC and this expression pattern was significantly associated with nodal metastasis. β-catenin expression correlated with the upregulation of LEF1 in IMPC. LEF1 expression was detected in 26 of 40 (65%) cases and was specifically enriched at the invasive front of the tumor and in tumor clusters undergoing LVI. Detection of LEF1 expression in the primary tumor was associated with an increased rate of LVI, lymph node metastasis, and disease relapse. LEF1 and β-catenin expression levels were significantly higher in metastases compared with primary tumors. In summary, this study demonstrates an association between the upregulation of β-catenin/LEF1 and the metastasis of IMPC.
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Affiliation(s)
- Darin Dolezal
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA 06510
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14
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Wang H, Yang K, Li Q, Su W, Liu X, Feng K, Song H, Li S, Jiang H. The study of clinicopathologic features of cervical squamous carcinoma with invasive micropapillary like pattern and phenotype. Histol Histopathol 2022; 37:853-861. [PMID: 35510512 DOI: 10.14670/hh-18-464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Invasive micropapillary carcinoma has been reported in the adenocarcinoma of many organs including cervix, and many studies have proved it has more invasive biological behavior. This study, for the first time, reports cervical squamous carcinoma with invasive micropapillary like pattern and phenotype (IMLPP) and further investigates its clinicopathologic features. Cervical squamous carcinoma with IMLPP was selected by histological characteristics and immunohistochemical staining. All patients' clinical information and pathological parameters were collected. Based on histological characteristics and immunohistochemical staining results, 24 cases, out of 104 cases of cervical squamous carcinoma, were identified as having invasive micropapillary like pattern. The staining of all 24 cases with EMA and MUC-1 showed the feature of "reverse polarity like". Meanwhile, patient age at diagnosis (P=0.011), maximum invasion depth (P=0.001), maximum diameter (P=0.015), lymphvascular space invasion (P<0.001), pelvic lymph node metastasis (P<0.001), metastasis (P=0.020), death (P=0.025) and FIGO stages (P=0.001) were related to the existence of IMLPP, independently of the proportion of IMLPP to the whole tumor in size. Univariate and multivariate disease-free survival analyses (follow-up time >12 months) showed significant statistical difference between cervical squamous carcinoma with or without IMLPP (P=0.016, P=0.043). Results from our study suggested that IMLPP may be associated with aggressive biological behavior in cervical squamous carcinoma. Therefore, pathologists should pay attention to the existence of it, no matter its proportion with relation to the whole tumor, and bring it to the attention of clinicians.
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Affiliation(s)
- Hongyu Wang
- Department of Pathology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Kun Yang
- Central Laboratory, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qiuyao Li
- Department of Pathology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.
| | - Wenjing Su
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Xiaoqian Liu
- Department of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Kun Feng
- Department of Pathology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Haiyun Song
- Department of Pathology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Shuen Li
- Department of Pathology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Huifeng Jiang
- Department of Pathology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
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Sun Y, Gu W, Wang G, Zhou X. The clinicopathological and prognostic characteristics of mucinous micropapillary carcinoma of the breast. Histol Histopathol 2022; 37:691-698. [PMID: 35166367 DOI: 10.14670/hh-18-436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Mucinous micropapillary carcinoma (MMPC) is a unique subtype of breast cancer, and there is as yet no detailed report on the clinical characteristics of MMPC. METHODS MMPC, pure mucinous breast carcinoma (PMBC), and invasive micropapillary carcinoma (IMPC) samples were enrolled simultaneously, and immunohistochemistry analysis was performed to explore the clinicopathological attributes of MMPC. Moreover, survival analyses of MMPC were performed among the MMPC, PMBC, and IMPC groups and within the MMPC group. RESULTS The results showed that MMPC demonstrated distinct pathological features and that vascular invasion and lymph node metastasis were two significant clinical attributes of MMPC. MMPC leads to a shorter survival time than PMBC but an increased survival time compared to IMPC, while the tumor-node-metastasis stage and lymph node metastasis were identified as two independent prognostic elements for disease-free survival in discerning the MMPC prognosis. CONCLUSIONS The gathered data implied that further understanding and classification of MMPC may provide better individualized therapeutic strategies for MMPC treatment.
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Affiliation(s)
- Yangyang Sun
- Department of Pathology, Changzhou No. 2 People's Hospital Affiliated with Nanjing Medical University, Changzhou, China
| | - Wenxian Gu
- Department of Pathology, Changzhou No. 2 People's Hospital Affiliated with Nanjing Medical University, Changzhou, China
| | - Gengfang Wang
- Department of Pathology, Changzhou No. 2 People's Hospital Affiliated with Nanjing Medical University, Changzhou, China
| | - Xiaoli Zhou
- Department of Pathology, Changzhou No. 2 People's Hospital Affiliated with Nanjing Medical University, Changzhou, China.
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Evaluation of Lymph Node Metastasis in Invasive Micropapillary Breast Carcinoma and Other Its Related Variables. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2022. [DOI: 10.5812/ijcm-112374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: The rate of lymph node metastasis in patients with invasive micropapillary carcinoma (IMPC) could be considered a critical prognostic factor whose measurement may enhance therapeutic outcomes in these patients. Objectives: The current study aims at determining the rate of lymph node involvement in IMPC patients and comparing it with that of invasive ductal carcinoma, not otherwise specified (IDC-NOS) patients. Methods: In this case-control study, a total of 124 participated, including 61 patients with IMPC and 63 patients with IDC-NOS. The rate of lymph node metastasis and its possible connection with the patient's age, tumor size, grade and focality, lymphovascular invasion, and proportion of micropapillary component were determined in patients with IMPC and compared to that of IDC-NOS patients. Results: Lymph node involvement was detected in 80.3% of patients with IMPC, which is significantly higher compared to patients with IDC-NOS. No significant correlation was found between lymph node metastasis and the patients’ age, tumor size, and focality in both IMPC and IDC-NOS groups. Furthermore, no significant relationship was observed between lymph node metastasis and tumor grade in IMPC, while metastasis to lymph nodes was directly correlated with higher tumor grades of NOS type. Moreover, in both types of cancer, lymph node metastasis was significantly associated with lymphovascular invasion. In patients with IMPC, no statistically significant relevance was observed between lymph node metastasis and the percentage of micropapillary components. Conclusions: According to the results of this study, patients with IMPC had a significantly higher rate of lymph node involvement compared to IDC-NOS. Hence, the rate of lymph node involvement could be used as a prognostic factor in these patients.
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Chen X, Zhang C, Guo D, Wang Y, Hu J, Hu J, Wang S, Liu X. Distant metastasis and prognostic factors in patients with invasive ductal carcinoma of the breast. Eur J Clin Invest 2022; 52:e13704. [PMID: 34725819 DOI: 10.1111/eci.13704] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the risk factors and prognostic factors of invasive ductal carcinoma (IDC) and to predict the survival of IDC patients with metastasis. METHOD We used multivariate logistic regression to identify independent risk factors affecting metastasis in IDC patients and used Cox regression to identify independent prognostic factors affecting the overall survival of patients with metastasis. Nomogram was used to predict survival, while C-index and calibration curves were used to measure the performance of nomogram. Kaplan-Meier method was used to calculate the survival curves of patients with different independent prognostics factors and different metastatic sites, and the differences were compared by log-rank test. The data of our study were obtained from the Surveillance, Epidemiology and End Results cancer registry. RESULT Our study included 226,094 patients with IDC. In multivariate analysis, independent risk factors of metastasis included age, race, marital status, income, geographic region, grade, T stage, N stage, subtype, surgery and radiotherapy. Independent prognostic factors included age, race, marital status, income, geographic region, grade, T stage, N stage, subtype, surgery and chemotherapy. We established a nomogram, of which the C-index was 0.701 (0.693, 0.709), with the calibration curves showing that the disease-specific survival between actual observation and prediction had a good consistency. The survival curves of different metastatic patterns were significantly different (log-rank test: χ2 = 18784, p < 0.001; χ2 = 47.1, p < 0.001; χ2 = 20, p < 0.001). CONCLUSION The nomogram we established may provide risk assessment and survival prediction for IDC patients with metastasis, which can be used for clinical decision-making and reference.
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Affiliation(s)
- Xiaofei Chen
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Chenyang Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Dingjie Guo
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yashan Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Junjun Hu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jiayi Hu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Song Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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Verras GI, Tchabashvili L, Mulita F, Grypari IM, Sourouni S, Panagodimou E, Argentou MI. Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis. BREAST CANCER (DOVE MEDICAL PRESS) 2022; 14:41-61. [PMID: 35310681 PMCID: PMC8926414 DOI: 10.2147/bctt.s346301] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/29/2022] [Indexed: 02/05/2023]
Abstract
Invasive micropapillary carcinoma (IMPC) of the breast is an infrequent type of breast cancer often discussed for its potency for lymphovascular invasion and difficulty in accurate imaging estimation. Micropapillary carcinomas are noted to be present as larger tumors, of higher histological grade and a notably higher percentage of disease-positive lymph nodes. Hormonal and HER-2 positivity in IMPC is also commoner when compared to other NST carcinomas. IMPC occurs either as a pure form or more often as a component of mixed Non-Specific Type (NST) carcinoma. The latest data suggest that despite having comparable survival rates to other histological subtypes of breast carcinoma, effective surgical treatment often requires extended surgical margins and vigilant preoperative axillary staging due to an increased incidence of lymph node invasion, and locoregional recurrence. Moreover, the presence of micropapillary in situ components within tumors also seems to alter tumor aggression and influence the nodal disease stage. In this review, we present an overview of the current literature of micropapillary carcinoma of the breast from biology to prognosis, focusing on biological differences and treatment.
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Affiliation(s)
| | - Levan Tchabashvili
- Department of Surgery, Breast Unit, University Hospital of Patras, Patras, Greece
| | - Francesk Mulita
- Department of Surgery, Breast Unit, University Hospital of Patras, Patras, Greece
| | | | - Sofia Sourouni
- Department of Radiology, University Hospital of Patras, Patras, Greece
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19
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Verras GI, Mulita F, Tchabashvili L, Grypari IM, Sourouni S, Panagodimou E, Argentou MI. A rare case of invasive micropapillary carcinoma of the breast. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2022; 21:73-80. [PMID: 35388282 PMCID: PMC8966417 DOI: 10.5114/pm.2022.113834] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
| | - Francesk Mulita
- Department of Surgery, Breast Unit, General University Hospital of Patras, Greece
- Corresponding author: Francesk Mulita, MD, Department of Surgery, Breast Unit, General University Hospital of Patras, Greece, e-mail:
| | - Levan Tchabashvili
- Department of Surgery, Breast Unit, General University Hospital of Patras, Greece
| | | | - Sofia Sourouni
- Department of Radiology, University Hospital of Patras, Greece
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20
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Chen X, Lin Y, Jin X, Zhang W, Guo W, Chen L, Chen M, Li Y, Fu F, Wang C. Integrative proteomic and phosphoproteomic profiling of invasive micropapillary breast carcinoma. J Proteomics 2022; 257:104511. [DOI: 10.1016/j.jprot.2022.104511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
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Kulka J, Madaras L, Floris G, Lax SF. Papillary lesions of the breast. Virchows Arch 2022; 480:65-84. [PMID: 34734332 PMCID: PMC8983543 DOI: 10.1007/s00428-021-03182-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/01/2021] [Accepted: 08/06/2021] [Indexed: 12/13/2022]
Abstract
Papillary lesions of the breast represent a heterogeneous group of lesions including benign papillomas, papillomas with focal epithelial atypia, fully fledged ductal carcinoma in situ (DCIS) or lobular neoplasia, papillary DCIS, encapsulated papillary carcinomas without or with invasion, solid papillary carcinomas, and invasive papillary carcinomas. A micropapillary pattern characterized by lack of fibrous stalks within the papillae is observed in micropapillary DCIS and invasive micropapillary carcinoma. In addition, a variety of other rare breast lesions reveals a papillary architecture such as tall cell carcinoma with reversed polarity (TCCRP) and mucinous cystadenocarcinoma, adenomyoepithelioma, and secretory carcinoma. In addition, benign lesions such as usual ductal hyperplasia, apocrine metaplasia, gynecomastia, and juvenile papillomatosis may show a papillary or micropapillary architecture. Fragments of a benign papilloma in a breast biopsy are considered a lesion of uncertain malignant potential (B3 in the European classification) and excision is mostly recommended. Although the knowledge about molecular pathology of papillary breast lesions has increased, there is not sufficient evidence for diagnostically useful molecular features, yet. The aim of this review is to provide an update on papillary and micropapillary lesions with emphasis on problematic areas for daily diagnostic work including biopsies.
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Affiliation(s)
- Janina Kulka
- 2nd Department of Pathology, Semmelweis University, Üllői út 93, 1091, Budapest, Hungary, E.U..
| | - Lilla Madaras
- 2nd Department of Pathology, Semmelweis University, Üllői út 93, 1091, Budapest, Hungary, E.U
- Department of Pathology, Uzsoki Hospital, Budapest, Hungary
| | - Giuseppe Floris
- Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research, KU Leuven, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Sigurd F Lax
- Department of Pathology, Hospital Graz II, Graz, Austria
- School of Medicine, Johannes Kepler University, Linz, Austria
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22
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Meng X, Ma H, Yin H, Yin H, Yu L, Liu L, Li T, Wang S, Xu Q. Nomogram Predicting the Risk of Locoregional Recurrence After Mastectomy for Invasive Micropapillary Carcinoma of the Breast. Clin Breast Cancer 2021; 21:e368-e376. [PMID: 33414079 DOI: 10.1016/j.clbc.2020.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The risk of locoregional recurrence (LRR) after mastectomy for breast invasive micropapillary carcinoma (IMPC) remains poorly defined. We aimed to construct an effective prognostic nomogram to estimate the individualized risk of LRR for providing accurate information for long-term follow-up. PATIENTS AND METHODS A total of 388 patients with breast IMPC were included in the current study. Based on the Cox regression and clinical significance, a nomogram with an online prediction version was created. This model was evaluated and internally validated by concordance index and calibration plot. Receiver operating characteristic curve and decision curve analysis were used to assess the discrimination and clinical utility, and Kaplan-Meier curves estimated the probability of LRR. RESULTS The variables (age, lymph node metastasis, hormone receptor status, lymphovascular invasion, histologic grade, and adjuvant radiotherapy) were included in the nomogram. This model was well-calibrated to predict the possibility of LRR and displayed favorable clinical utility; the concordance index was 0.86 (95% confidence interval, 0.81-0.91), which was higher than any single predictor. The area under the curve of the nomogram was 0.89, whereas that of the conventional staging system was 0.72. An online prognostic nomogram was built for convenient use. Kaplan-Meier curves showed that the nomogram had a better risk stratification than the conventional staging system. CONCLUSIONS The nomogram could accurately predict the individualized risk of LRR after mastectomy for breast IMPC. By identifying the risk stratification, this model is expected to assist clinicians and patients in improving long-term follow-up strategies.
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Affiliation(s)
- Xiangdi Meng
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Hongyu Ma
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Hang Yin
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Huizi Yin
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Lili Yu
- Department of Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Li Liu
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Tingting Li
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Siqi Wang
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Qingyong Xu
- Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
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Guan X, Xu G, Shi A, Zou Y, Zhan Y, Fan Z, Dong Y. Comparison of clinicopathological characteristics and prognosis among patients with pure invasive ductal carcinoma, invasive ductal carcinoma coexisted with invasive micropapillary carcinoma, and invasive ductal carcinoma coexisted with ductal carcinoma in situ: A retrospective cohort study. Medicine (Baltimore) 2020; 99:e23487. [PMID: 33327281 PMCID: PMC7738125 DOI: 10.1097/md.0000000000023487] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 02/02/2023] Open
Abstract
This paper aimed to analyze the clinicopathological characteristics of invasive ductal carcinoma with an invasive micropapillary carcinoma component (IDC + IMPC), invasive ductal carcinoma with a ductal carcinoma in situ component (IDC + DCIS), and compare the clinicopathological characteristics and prognosis to those of IDC.A total of 1713 patients (130 IDC + IMPC cases, 352 IDC + DCIS cases, and 1231 pure IDC cases) who underwent appropriate surgery from June 2011 to September 2017 were retrospectively selected.Compared to the pure IDC and IDC + DCIS patients, the IDC + IMPC patients presented with more aggressive characteristics, such as a higher proportion of vascular invasion (P < .001), fewer progesterone receptor (PR)-positive patients (P < .001), a lower proportion of cases in American Joint Committee on Cancer stage I (P < .001), a higher recurrence risk (P < .001), more deaths (P < .001), and more metastatic cases (P < .001). Compared to the pure IDC and IDC + IMPC patients, the IDC+DCIS patients presented with less aggressive characteristics, such as a higher proportion of estrogen receptor-positive patients (P < .001) and PR-positive patients (P < .001), a lower proportion of cases with nerve invasion (P < .001) and vascular invasion (P < .001), a higher proportion of cases in American Joint Committee on Cancer stage I (P < .001), fewer deaths (P < .001), and fewer metastatic cases (P < .001). The patients with IDC + DCIS had significantly better disease-free survival (DFS) and overall survival (OS) compared to those with pure IDC and IDC + IMPC (P < .001). The patients with IDC + IMPC had significantly worse DFS and OS compared to those with pure IDC and IDC + DCIS (P < .001). In univariate analysis, the presence of an IMPC component in IDC (P = .007), estrogen receptor status (P = .05), and PR status (P = .003) were factors associated with OS. In multivariate analysis, coexisting IMPC (P = .04) was the only independent prognostic factor associated with OS.Compared to IDC and IDC + DCIS, IDC + IMPC had more aggressive characteristics and significantly worse DFS and OS. Compared to IDC and IDC + IMPC, IDC + DCIS had less aggressive characteristics and significantly better DFS and OS.
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Affiliation(s)
- Xin Guan
- Department of Breast Surgery, The First Hospital of Jilin University
| | - Guiying Xu
- The Second Breast Surgery Department of Jilin Cancer Hospital
| | - Aiping Shi
- Department of Breast Surgery, The First Hospital of Jilin University
| | - Yabin Zou
- Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yue Zhan
- Department of Breast Surgery, The First Hospital of Jilin University
| | - Zhimin Fan
- Department of Breast Surgery, The First Hospital of Jilin University
| | - Yi Dong
- The Second Breast Surgery Department of Jilin Cancer Hospital
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24
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Perron M, Wen HY, Hanna MG, Brogi E, Ross DS. HER2 Immunohistochemistry in Invasive Micropapillary Breast Carcinoma: Complete Assessment of an Incomplete Pattern. Arch Pathol Lab Med 2020; 145:979-987. [PMID: 33212478 DOI: 10.5858/arpa.2020-0288-oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Invasive micropapillary carcinoma (IMPC) is a rare variant of breast carcinoma, composed of avascular morula-like tumor clusters surrounded by stromal spaces, which can affect the HER2 immunohistochemical (IHC) staining pattern. The 2013 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) HER2 testing guideline suggests moderate to intense but incomplete (basolateral) staining be considered equivocal. OBJECTIVES.— To perform a detailed assessment of HER2 IHC staining patterns in IMPC. DESIGN.— Hematoxylin-eosin and HER2 IHC slides were retrospectively reviewed to assess the morphology and HER2 IHC characteristics of IMPC. The 2018 ASCO/CAP guideline was applied. RESULTS.— The cohort consisted of 187 IMPCs from 181 patients with median age of 58 years. Homogeneous (≥90%) micropapillary component was found in 40% (75 of 187) of cases. Receptor profile was as follows: 75% (140 of 187) ER+ HER2-, 19% (37 of 187) ER+ HER2+, 4% (7 of 187) ER- HER2+, and 2% (3 of 187) ER- HER2-. Of 26 cases with HER2 IHC 3+, 65% (17 of 26) showed a basolateral staining pattern with strong intensity. HER2 fluorescence in situ hybridization (FISH) showed amplification in 26% (17 of 66) of HER2 IHC equivocal cases: 76% (13 of 17) showed basolateral staining pattern and 24% (4 of 17) complete staining, with weak to moderate (2), moderate (14), or moderate to strong (1) intensity. CONCLUSIONS.— The most frequent staining pattern was basolateral, seen in 49% of cases, including 65% HER2 IHC positive and 76% HER2 IHC equivocal/FISH amplified. If a basolateral pattern and weak to moderate staining is observed in IMPC, alternative testing should be performed to confirm the HER2 status.
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Affiliation(s)
- Marjorie Perron
- From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hannah Y Wen
- From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Matthew G Hanna
- From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Edi Brogi
- From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Dara S Ross
- From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
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25
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Assessment of stromal tumor infiltrating lymphocytes and immunohistochemical features in invasive micropapillary breast carcinoma with long-term outcomes. Breast Cancer Res Treat 2020; 184:985-998. [PMID: 32920743 DOI: 10.1007/s10549-020-05913-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/01/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE We studied the long-term outcomes of invasive micropapillary carcinoma (IMPCs) of the breast in relation to stromal tumor infiltrating lymphocytes (sTILs), prognostic biomarkers and clinicopathological features. METHODS Stage I-III IMPCs treated with upfront surgery at our institution (January 2000 and December 2016) were included. Central pathology review was performed and sTILs (including zonal distribution and hot spot analysis) and tumor-associated plasma cells (TAPC) were evaluated. Expression of P53, BCL2, FOXP3, and WT1, which are variably linked to breast cancer prognosis, was measured by immunohistochemistry using tissue microarrays. Time-to-event endpoints were distant recurrence free interval (DRFI) and breast cancer-specific survival (BCSS). RESULTS We included 111 patients of whom 59% were pure IMPCs. Standard clinicopathological features were comparable between pure and non-pure IMPCs. Overall, the mean sTILs level was 20% with higher proportion of sTILs present at the invasive front. There were no significant differences between pure- and non-pure IMPCs in sTILs levels, nor in the spatial distribution of the hot spot regions or in the distribution of TAPC. Higher sTILs correlated with worse DRFI (HR = 1.55; p = 0.0172) and BCSS (HR = 2.10; p < 0.001). CONCLUSIONS Clinicopathological features, geographical distribution of sTILs and TAPC are similar between pure and non-pure IMPCs. Despite a high proportion of grade 3 tumors and lymph node involvement, we observed a low rate of distant recurrences and breast cancer-related death in this cohort of stage I-III IMPCs treated with primary surgery. Caution in interpretation of the observed prognostic correlations is required given the very low number of events, warranting validation in other cohorts.
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Kim J, Kim JY, Lee HB, Lee YJ, Seong MK, Paik N, Park WC, Park S, Jung SP, Bae SY. Characteristics and prognosis of 17 special histologic subtypes of invasive breast cancers according to World Health Organization classification: comparative analysis to invasive carcinoma of no special type. Breast Cancer Res Treat 2020; 184:527-542. [PMID: 32794061 DOI: 10.1007/s10549-020-05861-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Breast cancer is a heterogeneous disease with various histopathologic subtypes. Except for invasive carcinoma of no special type (NST), other subtypes are rare with limited data. The purpose of this study was to analyze the characteristics and prognosis of special histopathologic subtypes of breast cancer compared to NST. METHODS A total of 136,140 patients were analyzed using the Korean Breast Cancer Society Registry database between January 1996 and March 2019. The clinicopathologic features and survival outcomes of special type breast carcinoma were compared with those of NST. RESULTS The prevalence of special subtypes other than NST was 13.7% (n = 18,633). Compared to NST, patients with lobular, medullary, metaplastic, and micropapillary carcinoma had larger tumors (p < 0.001). Patients with mucinous, tubular, medullary, metaplastic, and cribriform carcinoma presented with less node metastasis (p < 0.001), contrary to patients with micropapillary carcinoma. Patients with lobular, mucinous, tubular, papillary, and cribriform carcinoma presented as luminal A subtype much more often (p < 0.001). Micropapillary carcinoma included more luminal B subtype (p < 0.001). Typically, medullary and metaplastic carcinoma included more triple-negative subtypes (p < 0.001). In survival analysis, only medullary (Hazard Ratio (HzR) 0.542, 95% CI 0.345 to 0.852, p = 0.008) and metaplastic carcinoma (HzR 1.655, 95% CI 1.317 to 2.080, p < 0.001) showed significantly different overall survival from NST by multivariate analysis. CONCLUSION Breast cancer had distinct clinicopathologic features according to histopathologic subtype. However, special types of breast cancer had similar survival outcomes compared to NST when adjusting for other prognostic factors, except for metaplastic carcinoma and medullary carcinoma.
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Affiliation(s)
- Jiyoung Kim
- Department of Surgery, Daerim St. Mary's Hospital, Seoul, South Korea
| | - Jee Ye Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Han-Byoel Lee
- Department of Surgery, Seoul National University College of Medicine, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Young Joo Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Min-Ki Seong
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Namsun Paik
- Ewha Womans University Cancer Center Hospital for Women, Seoul, South Korea
| | - Woo-Chan Park
- Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - Sungmin Park
- Department of Breast Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-si, Republic of Korea
| | - Seung Pil Jung
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, 02841, Seoul, Republic of Korea
| | - Soo Youn Bae
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, 02841, Seoul, Republic of Korea.
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Abstract
Micropapillary adenocarcinoma has been reported as an aggressive variant of adenocarcinoma in several organs, where it is associated with poor clinical outcome. This study reports the clinicopathologic features and outcomes of cervical adenocarcinomas with a micropapillary component (micropapillary cervical adenocarcinomas); this represents the largest reported study of these neoplasms. The study comprised 44 cervical adenocarcinomas of usual (human papillomavirus-related)-type (84%), mucinous, not otherwise specified (4.5%), gastric-type (4.5%), endometrioid (4.5%), and adenosquamous carcinoma (2%). The micropapillary component comprised >50% of the neoplasm in 34 cases (77%) (group 1), and 10% to 50% in 10 cases (23%) (group 2). Lymph node metastasis was present in 41 of 44 (93%) cases and typically the nodal tumor retained a prominent micropapillary morphology. Follow-up ranged from 7 to 123 months (mean, 65.9 mo). Seventeen of 44 (38.6%) patients had no evidence of disease on follow-up, 6/44 (13.6%) were alive with disease, and 21/44 (47.7%) died of disease. There were no survival differences between group 1 and group 2. On univariate analysis, lymph node metastasis (P=0.0015), lymphovascular space invasion (P=0.002), parametrial involvement (P=0.03), and depth of stromal invasion (P=0.045) were related to tumor recurrence. On multivariate analysis, lymph node metastasis (P=0.001), and extent of lymphovascular space invasion (P=0.027) were significant independent predictors of tumor recurrence. Our study shows that a micropapillary component in cervical adenocarcinoma may be associated with aggressive behavior and that a micropapillary architecture may occur within a variety of types of cervical adenocarcinoma.
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Ye F, Yu P, Li N, Yang A, Xie X, Tang H, Liu P. Prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in breast: A meta-analysis of PSM studies. Breast 2020; 51:11-20. [PMID: 32172190 PMCID: PMC7375573 DOI: 10.1016/j.breast.2020.01.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Invasive micropapillary carcinoma (IMPC) is a rare histological subtype of breast cancer. The outcome of IMPC remains controversial; we conducted a meta-analysis of propensity score matching (PSM) studies to evaluate the prognostic difference between IMPC and invasive ductal carcinoma (IDC). METHODS We searched PubMed, EMBASE and the Cochrane library for PSM studies comparing survival data between IMPC and IDC. The summarized odds ratios (ORs) and 95% confidence interval (95% CI) are calculated by STATA software utilizing fixed-effect or random-effect models, depending on the heterogeneity of the eligible studies. RESULTS Eight PSM studies including 2102 IMPC patients are included in the meta-analysis. Compared with IDC, IMPC has a similar overall survival (OS) (estimated OR = 0.87, 95% CI: 0.61-1.25), but a shorter relapse free survival (RFS) (estimated OR = 1.31, 95% CI: 1.06-1.61); the shorter RFS might owe to the significantly higher loco-regional recurrence rate of IMPC (estimated OR = 3.60, 95% CI: 1.99-6.52). Funnel plots and Egger's tests are used to evaluate publication bias and the p value for OS and RFS are 0.036 and 0.564 respectively. CONCLUSIONS Our results demonstrate that compared with IDC, IMPC exhibits a similar, even favorite OS, but a shorter RFS; and the shorter RFS might owe to the significantly higher loco-regional recurrence rate of IMPC. These results could contribute to the individualized therapy and follow-up strategies for IMPC patients.
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Affiliation(s)
- Feng Ye
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
| | - Ping Yu
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
| | - Na Li
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
| | - Anli Yang
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
| | - Xinhua Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
| | - Hailin Tang
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
| | - Peng Liu
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
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Li D, Zhong C, Cheng Y, Zhu N, Tan Y, Zhu L, Xu D, Yuan Y. A Competing Nomogram to Predict Survival Outcomes in Invasive Micropapillary Breast Cancer. J Cancer 2019; 10:6801-6812. [PMID: 31839814 PMCID: PMC6909950 DOI: 10.7150/jca.27955] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/14/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Although it is widely accepted that invasive micropapillary carcinoma (IMPC) presents more aggressive behavior and has a higher aggressive behavior, the prognosis of IMPC compared with invasive ductal carcinoma (IDC) remains controversial. We conducted this study to explore gene expression profiles of IMPC and establish a competing nomogram that predicts the survival outcomes across these two groups of patients. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) database were reviewed. Propensity score matching (PSM) was used to adjust for potential baseline confounding between IMPC and IDC group. The Kaplan-Meier method was used to calculate the occurrence of overall mortality. The Gray method was used to estimate the rate of breast cancer specific death (BCSD). A competing regression model was used to evaluate factors associated with BCSD. A nomogram based on the competing risk regression model was established to predict individual outcomes. IMPC-specific gene expression profiles were explored using microarrays data from the Gene Expression Omnibus (GEO) database. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) enrichment analyses were performed. Results: In this study, 330786 (99.62%) patients with IDC 1247 (0.38%) patients with IMPC were included. Patients with IMPC had more lymph node involvement and a larger tumor size compared with those with IDC. After PSM, many distributional differences were eliminated, showing that the IMPC and IDC group were more similar. Patients with IMPC had a favorable prognosis with statistical significance compared with patients with IDC (overall mortality HR = 0.68; 95%CI, 0.53-0.86; P = 0.002). Based on Gray method, patients with IMPC had a favorable prognosis with significant statistical significance compared with patients with IDC (BCSD SHR = 0.64; 95%CI, 0.47-0.88; P = 0.006). Multivariate analysis based on competing risk model demonstrated that IMPC was a favorable independent factor for BCSD. The nomogram could accurately predict BCSD with a high internal and external validated C-index (0.835, 0.818 respectively). A total of 53 upregulated differentially expressed genes (DEGs) and 40 downregulated DEGs of IMPC was identified. The GO analysis results showed that downregulated DEGs were significantly enriched in extracellular structure organization, extracellular matrix, cell-substrate adhesion junction. KEGG analysis of selective gene sets shows that downregulated DEGs significantly enriched for processes related to carbon metabolism, Rap1 signaling pathway. Conclusion: In the current study, IMPC accounted for 0.38% of the entire cohort. IMPC was found to be a favorable independent prognostic factor. The present study identified gene expression profiles and signal pathways of IMPC. The developed nomogram can help the oncologists to predict individual outcomes more accurately.
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Affiliation(s)
- Dan Li
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Chenhan Zhong
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yi Cheng
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Ning Zhu
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yinuo Tan
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Lizhen Zhu
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Dong Xu
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education; Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Ying Yuan
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education; Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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Yoon GY, Cha JH, Kim HH, Shin HJ, Chae EY, Choi WJ. Comparison of invasive micropapillary and invasive ductal carcinoma of the breast: a matched cohort study. Acta Radiol 2019; 60:1405-1413. [PMID: 30897929 DOI: 10.1177/0284185119834689] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Ga Young Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Joo Hee Cha
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hak Hee Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hee Jung Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Eun Young Chae
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Woo Jung Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Lewis GD, Xing Y, Haque W, Patel T, Schwartz M, Chen A, Farach A, Hatch SS, Butler EB, Chang J, Teh BS. Prognosis of lymphotropic invasive micropapillary breast carcinoma analyzed by using data from the National Cancer Database. Cancer Commun (Lond) 2019; 39:60. [PMID: 31639071 PMCID: PMC6805396 DOI: 10.1186/s40880-019-0406-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background Invasive micropapillary carcinoma (IMPC) is an uncommon subtype of breast cancer. Previous studies of this subtype demonstrated a higher propensity for lymph node metastases as compared with invasive ductal carcinoma (IDC). The purpose of the present study was to determine the clinical characteristics, outcomes, and propensity for lymph node metastasis of patients with IMPC of the breast recorded in the National Cancer Database (NCDB). Methods Records of patients with IMPC diagnosed between 2004 and 2014 were retrieved from the NCDB. Log-rank test was performed to evaluate associations of clinical characteristics with overall survival (OS). Cox proportional hazards model was used to determine variables associated with OS. Results Overall, 2660 patients with IMPC met the selection criteria; the 5-year OS rate was 87.5% and 24.9% of patients had nodal involvement at presentation. Patients with ≥ 4 positive lymph nodes had shorter OS than node-negative patients, whereas patients with 1–3 positive nodes had similar OS to node-negative patients. Age < 65 years, receipt of radiotherapy, and estrogen receptor positivity were also associated with prolonged OS. The benefit of radiotherapy was limited to IMPC patients undergoing lumpectomy; there was no benefit for the patients undergoing mastectomy (regardless of nodal positivity/negativity). Conclusions Favorable prognostic factors of IMPC patients included age < 65 years, < 4 positive lymph nodes, receipt of radiotherapy, and estrogen receptor positivity. The results presented herein suggest a survival benefit associated with radiotherapy in IMPC treatment, though this may be limited to the patients treated with lumpectomy.
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Affiliation(s)
- Gary D Lewis
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Yan Xing
- Department of Medicine, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Waqar Haque
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Tejal Patel
- Department of Medicine, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Mary Schwartz
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Albert Chen
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Andrew Farach
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Sandra S Hatch
- Department of Radiation Oncology, The University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - E Brian Butler
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Jenny Chang
- Department of Medicine, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, 77030, USA.
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Lewis GD, Xing Y, Haque W, Patel T, Schwartz MR, Chen AC, Farach A, Hatch SS, Butler EB, Chang JC, Teh BS. The impact of molecular status on survival outcomes for invasive micropapillary carcinoma of the breast. Breast J 2019; 25:1171-1176. [PMID: 31321854 DOI: 10.1111/tbj.13432] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 01/17/2023]
Abstract
Invasive micropapillary carcinoma (IMPC) is an uncommon variant of breast cancer. Previous studies demonstrated this subtype is often hormone receptor (HR)-positive, resulting in survival outcomes similar to invasive ductal carcinoma. However, many of these studies were conducted prior to HER2 testing availability. We aim to determine the impact of molecular marker status (including HER2 status) on IMPC survival outcomes. The National Cancer Data Base (NCDB) was used to retrieve patients with biopsy-proven IMPC from 2007 to 2012. Only patients with known HR and HER2 status were included. Cox multivariate regression was used to determine prognostic factors. In total, 865 patients were included; median follow-up was 2.5 years. Overall, 651 patients (75.3%) had HR + HER2- disease, 128 (14.8%) had HR + HER2+ disease, 41 (4.7%) had HR-HER2 + disease, and 45 (5.2%) had triple negative disease. Patients with triple negative disease were more likely to have poorly differentiated histology (66.7%), lymphovascular invasion (73.3%), stage 3 disease (37.8%), undergone mastectomy (68.9%), and positive surgical margins (15.6%). On Cox multivariate regression, those with triple negative disease had worse overall survival (hazard ratio [HR] 7.28, P < 0.001). Other adverse prognostic factors included African-American descent (HR 2.24, P = 0.018), comorbidity score of 1 (HR 2.50, P = 0.011), comorbidity score ≥2 (HR 3.27, P = 0.06), and ≥3 positive lymph nodes (HR 3.23, P = 0.007). Similar to invasive ductal carcinoma, triple negative disease in IMPC results in worse survival outcomes. This is the largest and first study to characterize molecular status (including HER2 status) in patients with IMPC and its impact on survival outcomes.
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Affiliation(s)
- Gary D Lewis
- Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, Texas.,Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Yan Xing
- Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Waqar Haque
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Tejal Patel
- Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Mary R Schwartz
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Albert C Chen
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas
| | - Andrew Farach
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Sandra S Hatch
- Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, Texas
| | - E Brian Butler
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Jenny C Chang
- Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
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Huang L, Ji H, Yin L, Niu X, Wang Y, Liu Y, Xuan Q, Li L, Zhang H, Zhou X, Li J, Cui C, Yang Y, An W, Zhang Q. High Expression of Plakoglobin Promotes Metastasis in Invasive Micropapillary Carcinoma of the Breast via Tumor Cluster Formation. J Cancer 2019; 10:2800-2810. [PMID: 31258788 PMCID: PMC6584935 DOI: 10.7150/jca.31411] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 04/06/2019] [Indexed: 01/22/2023] Open
Abstract
Invasive micropapillary carcinoma of the breast (IMPC) is a rare subtype of breast cancer that has a high frequency of lymph node (LN) involvement and metastasis to distant organs. IMPC is characterized by distinct histomorphology and unfavorable prognosis when compared with invasive ductal carcinoma no special type (IDC-NST). However, the underlying molecular mechanisms remain unclear. We reported here that plakoglobin, as a key component in cell adhesion, can promote collective metastasis through facilitating IMPC clusters formation. In comparing the clinicopathological features of 451 IMPC patients and 282 IDC-NST patients, our results showed that tumor emboli were significantly higher in IMPC patients and were associated with a high frequency of metastasis. Both in vitro and in vivo data showed overexpression of plakoglobin in both the cell membrane and the cytoplasm of IMPC clusters. When plakoglobin was knocked down in IMPC cell models, the tumor cell clusters were depolymerized. Using mouse models, we validated the metastatic potential of tumor clusters was higher than single cells in vivo. Further analysis showed that higher expression of plakoglobin was able to promote activation of the PI3K/Akt/Bcl-2 pathway, which might protect the clusters from anoikis. Our data indicate that plakoglobin promotes tumor cluster formation in IMPC and downregulates apoptosis in the cell clusters through activation of PI3K/Akt/Bcl-2 signaling. These results provide a convincing rationale for the high metastatic propensity seen in IMPC.
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Affiliation(s)
- Lan Huang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Hongfei Ji
- Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin 150081, Heilongjiang, China.,Heilongjiang Academy of Medical Sciences, Harbin 150081, Heilongjiang, China
| | - Lei Yin
- Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin 150081, Heilongjiang, China.,Heilongjiang Academy of Medical Sciences, Harbin 150081, Heilongjiang, China
| | - Xingjian Niu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Yiran Wang
- Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin 150081, Heilongjiang, China.,Heilongjiang Academy of Medical Sciences, Harbin 150081, Heilongjiang, China
| | - Yang Liu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang, China
| | - Qijia Xuan
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Liru Li
- Heilongjiang Academy of Medical Sciences, Harbin 150081, Heilongjiang, China
| | - Han Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Xiaoping Zhou
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Jingtong Li
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Chengwei Cui
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Yue Yang
- Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin 150081, Heilongjiang, China.,Heilongjiang Academy of Medical Sciences, Harbin 150081, Heilongjiang, China
| | - Weiwei An
- Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin 150081, Heilongjiang, China.,Heilongjiang Academy of Medical Sciences, Harbin 150081, Heilongjiang, China
| | - Qingyuan Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China.,Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin 150081, Heilongjiang, China.,Heilongjiang Academy of Medical Sciences, Harbin 150081, Heilongjiang, China
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Invasive micropapillary carcinoma of the breast had no difference in prognosis compared with invasive ductal carcinoma: a propensity-matched analysis. Sci Rep 2019; 9:286. [PMID: 30670771 PMCID: PMC6343026 DOI: 10.1038/s41598-018-36362-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 10/26/2018] [Indexed: 12/15/2022] Open
Abstract
Invasive micropapillary carcinoma (IMPC) is a rare histopathological variant of breast carcinoma that is usually associated with poor clinical characteristics. Whether IMPC has worse prognosis than invasive ductal carcinoma (IDC) is controversial. This retrospective study examined the prognostic difference between IMPC and IDC. We analysed 327 cases of IMPC patients and 4979 IDC cases who underwent primary resection in our institution between 2008 and 2012. Using propensity score matching, the two groups were matched at 1:1 by age, tumour size, nodal status, hormone status, and HER2 status. Differences in prognosis were assessed by Kaplan-Meier estimates and Cox regression analysis. We established the IMPC group and identified 324 IDC patients by propensity score matching. The survival analysis indicated that IMPC patients had no significant reduced overall survival (p = 0.752) or disease-free survival (p = 0.578) compared with IDC patients. Multivariate Cox regression analysis revealed that IMPC was not an independent prognostic factor for disease-free survival (hazard ratio [HR] = 0.944; 95% confidential interval [CI], 0.601–1.481) or overall survival (HR = 0.727; 95% CI, 0.358–1.478). Survival analysis demonstrated no statistically significant difference between IMPC and IDC, indicating that proactive or radical clinical therapy is unnecessary.
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Hashmi AA, Aijaz S, Mahboob R, Khan SM, Irfan M, Iftikhar N, Nisar M, Siddiqui M, Edhi MM, Faridi N, Khan A. Clinicopathologic features of invasive metaplastic and micropapillary breast carcinoma: comparison with invasive ductal carcinoma of breast. BMC Res Notes 2018; 11:531. [PMID: 30064485 PMCID: PMC6069771 DOI: 10.1186/s13104-018-3623-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/20/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives The aim of this study was to determine the frequency of metaplastic breast carcinoma and invasive micropapillary carcinoma in our population and also to compare the clinico-pathologic features of metaplastic breast carcinoma and invasive micropapillary carcinoma with invasive ductal carcinoma, not otherwise specified (IDC, NOS). Results 86.9% of the cases were identified as ductal carcinoma, NOS, while 2.2% were metaplastic and 0.76% cases were micropapillary carcinoma. Metaplastic carcinomas were found to be of higher grade as compared to IDC, NOS as 81% of metaplastic carcinoma were grade III compared to 35% IDC, NOS. 79% of metaplastic carcinoma were ER negative and 86% were PR negative, respectively as compared to ductal carcinoma NOS, which were 40% ER negative and 54% were PR. Similarly, 86.7% micropapillary cancers were ER positive and 73.3% were PR positive. Moreover, 66.7% micropapillary carcinoma showed nodal metastasis and 77.8% showed lymphovascular invasion, which was significantly higher than that of IDC, NOS micropapillary and metaplastic carcinomas accounts for less than 2 and 1% of the breast cancer burden in our population and highly correlates with poor prognosis parameters therefore, require more intensive management in our population.
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Affiliation(s)
- Atif Ali Hashmi
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Saher Aijaz
- Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | - Raeesa Mahboob
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | | | - Muhammad Irfan
- Department of Statistics, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Narisa Iftikhar
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Mariam Nisar
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | | | | | - Naveen Faridi
- Department of Pathology, National Hospital and Medical College, Karachi, Pakistan
| | - Amir Khan
- Department of Medicine, Kandahar University, Kandahar, Afghanistan.
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Precise pathologic diagnosis and individualized treatment improve the outcomes of invasive micropapillary carcinoma of the breast: a 12-year prospective clinical study. Mod Pathol 2018; 31:956-964. [PMID: 29403084 DOI: 10.1038/s41379-018-0024-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/28/2017] [Accepted: 12/30/2017] [Indexed: 02/04/2023]
Abstract
Invasive micropapillary carcinoma of the breast is a histologic subtype of breast cancer and associated with high incidence of lymphovascular invasion, lymph node metastasis and poor prognosis. The aim of this prospective study was to investigate the impact of precise pathologic diagnosis and individualized treatment on the outcomes of invasive micropapillary carcinoma of the breast. The study group included 2299 women with invasive micropapillary carcinoma diagnosed at Tianjin Medical University Cancer Institute and Hospital between January 2004 and December 2015. In the study group, specimens were examined with the method of whole-specimen orientation and serial sectioning, and patients received precise pathological diagnosis and individualized treatment. The control group of invasive micropapillary carcinoma consisted of 163 cases, identified through a retrospectively review of 9056 invasive carcinomas diagnosed at our institution between January 1989 and December 2003 using the standard pathology-evaluation method (i.e., not using the whole-specimen orientation and serial-sectioning method). The clinicopathological features, treatments and outcomes were compared between the two groups. The incidence of invasive micropapillary carcinoma in the study group was 6% (2299/39,714 cases), significantly higher than that of the control group (2%; 163/9056 cases). The 5-year disease-free survival in the study group was significantly higher than that in the control group (83.8 vs.45.4%; p < 0.05). The 5-year overall survival was significantly increased from 57.4% in the control group to 90.9% in the study group (p < 0.05). In the multivariate analysis, lymphovascular invasion, estrogen receptor status and lymph node metastasis were independent prognostic factors. Although invasive micropapillary carcinoma of the breast is associated with poor prognosis, precise pathologic diagnosis and individualized treatment improved the disease-free survival and overall survival of invasive micropapillary carcinoma patients. Precise pathological diagnosis is the premises for individualized treatments and for improving the outcomes of patients with invasive micropapillary carcinoma of the breast.
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Kaya C, Uçak R, Bozkurt E, Ömeroğlu S, Kartal K, Yazıcı P, İdiz UO, Mihmanlı M. The Impact of Micropapillary Component Ratio on the Prognosis of Patients With Invasive Micropapillary Breast Carcinoma. J INVEST SURG 2018; 33:31-39. [PMID: 29843540 DOI: 10.1080/08941939.2018.1474302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background and Objectives: Invasive micropapillary carcinoma (IMPC) of the breast is a rare and aggressive variant of invasive ductal carcinoma characterized by high-grade lymphovascular invasion and high rates of nodal metastasis. The prognostic significance of the micropapillary component (MC) ratio that constitutes this aggressive variation is controversial. In this study, we aimed to investigate the effect of the MC ratio on the prognosis of these patients. Methods: The data of 47 patients with IMPC were retrospectively reviewed. Patients were divided into two groups: MC ratio of 10-75% (Group 1) and greater than 75% (Group 2). The demographic characteristics of the patients, histopathologic features of the tumors, and survival rates were compared. Results: We detected no significant difference in demographic characteristics between groups 1 and 2 (p = 0.21). No significant difference was detected in terms of tumor diameter, lymph node metastasis, lymphovascular invasion, histologic grade, multicentricity, local recurrence, distant metastasis, and overall survival. Conclusion: In the micropapillary subgroup of invasive ductal carcinoma, although positive receptor characteristics are directly proportional to the increase in MC ratio, recurrence and survival rates are not affected by micropapillary component level.
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Affiliation(s)
- Cemal Kaya
- Department of General Surgery, Istanbul Sisli Hamidiye Etfal Medical Practice and Research Center, University of Health Sciences, İstanbul, Turkey
| | - Ramazan Uçak
- Department of Pathology, Istanbul Sisli Hamidiye Etfal Medical Practice and Research Center, University of Health Sciences, İstanbul, Turkey
| | - Emre Bozkurt
- Department of General Surgery, Istanbul Sisli Hamidiye Etfal Medical Practice and Research Center, University of Health Sciences, İstanbul, Turkey
| | - Sinan Ömeroğlu
- Department of General Surgery, Hınıs Şehit Yavuz Yürekseven State Hospital, Erzurum, Turkey
| | - Kinyas Kartal
- Department of General Surgery, Istanbul Sisli Hamidiye Etfal Medical Practice and Research Center, University of Health Sciences, İstanbul, Turkey
| | - Pınar Yazıcı
- Department of General Surgery, Istanbul Sisli Hamidiye Etfal Medical Practice and Research Center, University of Health Sciences, İstanbul, Turkey
| | - Ufuk Oğuz İdiz
- Department of General Surgery, Istanbul Sisli Hamidiye Etfal Medical Practice and Research Center, University of Health Sciences, İstanbul, Turkey
| | - Mehmet Mihmanlı
- Department of General Surgery, Istanbul Sisli Hamidiye Etfal Medical Practice and Research Center, University of Health Sciences, İstanbul, Turkey
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Clinicopathologic study of invasive micropapillary carcinoma of the breast. Oncotarget 2018; 8:42455-42465. [PMID: 28418916 PMCID: PMC5522079 DOI: 10.18632/oncotarget.16405] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/21/2017] [Indexed: 02/05/2023] Open
Abstract
Invasive micropapillary carcinoma (IMPC) is a rare subtype of breast carcinoma. It is presumed to be more aggressive than invasive ductal carcinoma (IDC), though it is uncertain whether the prognoses of IMPC and IDC differ. In this retrospective study, we compared the clinicopathologic characteristics and survival between 170 female patients with IMPC (pure or mixed with IDC) and 728 with pure IDC. The IMPC patients had higher clinical stages and histologic grades, higher incidences of lymphovascular invasion and axillary lymph node extracapsular extension, and a higher degree of lymph node involvement than IDC patients. Moreover, IMPC was associated with increases in estrogen receptor (ER) and progesterone receptor (PR) positivity and HER-2 overexpression. Although locoregional recurrence-free survival (LRRFS) and recurrence-free survival (RFS) were poorer in IMPC patients than IDC patients, overall survival and distant metastasis survival did not differ between the two groups. Multivariate analysis revealed that IMPC was an independent prognostic factor for LRRFS in breast cancer, and IMPC patients had poorer clinicopathologic characteristics and poorer RFS and LRRFS than IDC patients. We therefore suggest that to improve treatment decisions, patients with breast carcinoma be tested for the presence of this specific subtype.
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Shuja J, Ahmad I, Arshad S, Manzoor H, Kakar S, Ahmad K. A Case Report of Triple-Positive Micropapillary Carcinoma of the Male Breast. Breast Care (Basel) 2018; 13:192-194. [PMID: 30069180 DOI: 10.1159/000486665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Micropapillary carcinoma (MPC), a morphologically distinct subtype of invasive ductal carcinoma, of the male breast is an exceedingly uncommon disease. Case Report Herein, we report a case of triple-positive MPC of the male breast with axillary lymph node involvement and no recurrence for over 2 years. Specifically, a 60-year-old male patient presented with a hard, elastic, and well-defined painless mass in the right breast. The patient underwent unilateral (right) modified radical mastectomy with axillary clearance. Histopathology revealed MPC grade 3 and metastasis in 16/16 lymph nodes. Hormone receptor analysis demonstrated strong positivity (total score 08) for estrogen/progesterone receptors and overexpression (score 3+) of human epidermal growth factor receptor 2. The patient received adjuvant chemotherapy (6 courses of CAF: cyclophosphamide, doxorubicin, and 5-fluorouracil), radiation, and tamoxifen. The patient has remained disease-free for over 2 years. Conclusion This study demonstrates that triple-positive MPC of the male breast as a rare malignancy appears to respond promisingly to multimodality treatment.
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Affiliation(s)
- Jamila Shuja
- Center for Nuclear Medicine and Radiotherapy (CENAR), Quetta, Pakistan
| | - Iftikhar Ahmad
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
| | - Sidra Arshad
- Agha Khan University Hospital, Karachi, Pakistan
| | - Hina Manzoor
- Center for Nuclear Medicine and Radiotherapy (CENAR), Quetta, Pakistan
| | | | - Khushnaseeb Ahmad
- Center for Nuclear Medicine and Radiotherapy (CENAR), Quetta, Pakistan
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Wu Y, Zhang N, Yang Q. The prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in the breast: a meta-analysis. BMC Cancer 2017; 17:839. [PMID: 29228910 PMCID: PMC5725780 DOI: 10.1186/s12885-017-3855-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 11/28/2017] [Indexed: 01/27/2023] Open
Abstract
Background Invasive micropapillary carcinoma (IMPC) of the breast is a rare variant of invasive ductal carcinoma (IDC). The prognosis of IMPC compared with that of IDC remains controversial; we conducted a meta-analysis to evaluate the prognostic difference between IMPC and IDC. Methods We searched the PubMed, Cochrane Library, and EMBASE databases for relevant studies comparing overall survival (OS), disease-specific survival (DSS), relapse-free survival (RFS), local-regional recurrence-free survival (LRRFS) or distant metastasis-free survival (DMFS) rates between IMPC and IDC. Fixed-effect and random-effect models were utilized based on the heterogeneity of the eligible studies. Heterogeneity was further evaluated by subgroup and sensitivity analyses. Results Fourteen studies with 1888 IMPC patients were included in the meta-analysis. The summarized odds ratio (OR) and 95% confidence interval (95% CI) was calculated to estimate the prognostic difference between IMPC and IDC. IMPC patients showed an unfavorable prognosis for RFS (OR; 2.04; 95% CI: 1.63–2.55) and LRRFS (OR: 2.82; 95% CI: 1.90–4.17) compared with IDC. However, no significant difference was observed in OS (OR: 0.93; 95% CI: 0.78–1.10), DSS (OR: 1.16; 95% CI: 0.95–1.40) and DMFS (OR: 0.95; 95% CI: 0.67–1.35) between IMPC and IDC. No obvious statistical heterogeneity was detected, except for DSS. Funnel plots and Egger’s tests did not reveal publication bias, except for RFS. Conclusions This analysis showed that IMPC patients have a higher rate of loco-regional recurrence than IDC patients. However, OS, DSS and DMFS were not significantly different between IMPC and IDC. These results could help clinicians select therapeutic and follow-up strategies for IMPC patients. Electronic supplementary material The online version of this article (10.1186/s12885-017-3855-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yun Wu
- Department of Breast Surgery, Qilu Hospital, Shandong University, No.107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ning Zhang
- Department of Breast Surgery, Qilu Hospital, Shandong University, No.107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Qifeng Yang
- Department of Breast Surgery, Qilu Hospital, Shandong University, No.107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China. .,Pathology Tissue Bank, Qilu Hospital, Shandong University, No.107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
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Chen H, Wu K, Wang M, Wang F, Zhang M, Zhang P. Invasive micropapillary carcinoma of the breast has a better long-term survival than invasive ductal carcinoma of the breast in spite of its aggressive clinical presentations: a comparison based on large population database and case-control analysis. Cancer Med 2017; 6:2775-2786. [PMID: 29072365 PMCID: PMC5727334 DOI: 10.1002/cam4.1227] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/17/2017] [Accepted: 09/19/2017] [Indexed: 11/15/2022] Open
Abstract
There are controversies in the comparison of overall survival between invasive micropapillary carcinoma of the breast (IMPC) and invasive ductal carcinoma (IDC). The objective of this study was to compare the long‐term survival outcome between non‐metastatic IMPC and IDC. The Surveillance, Epidemiology, and End Results database was searched to identify women with non‐metastatic IMPC and IDC diagnosed between 2001 and 2013. Comparisons of patient and tumor characteristics were performed using Pearson's chi‐square. The propensity score matching method was applied with each IMPC matched to one IDC. Breast cancer‐specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan–Meier product limit method and compared across groups using the log‐rank statistic. Multivariate analysis was performed through Cox models. IMPC was presented with aggressive clinical presentations such as larger tumor, more positive lymph nodes, and more advanced stage compared with IDC. A higher rate of estrogen receptor (ER)/progesterone receptor (PR) positivity was also observed in IMPC. With a median follow‐up of 64 months, IMPC had a better BCSS (P = 0.031) and OS (P = 0.012) compared with IDC. In a case–control analysis IMPC was still an independent favorable prognostic factor for BCSS (HR = 0.410, P < 0.001, 95% CI: 0.293–0.572) and OS (HR = 0.497, P < 0.001, 95% CI: 0.387–0.637). In subgroup analysis, IMPC always showed a better survival outcome compared with IDC except in AJCC stage I and histologic grade I disease. IMPC has a better long‐term survival outcome compared with IDC in spite of its highly aggressive clinical presentation.
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Affiliation(s)
- Hongliang Chen
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Kejin Wu
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Maoli Wang
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Fuwen Wang
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Mingdi Zhang
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Peng Zhang
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
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Wu SG, Zhang WW, Sun JY, Li FY, Chen YX, He ZY. Postoperative radiotherapy for invasive micropapillary carcinoma of the breast: an analysis of Surveillance, Epidemiology, and End Results database. Cancer Manag Res 2017; 9:453-459. [PMID: 29056854 PMCID: PMC5635851 DOI: 10.2147/cmar.s141338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction Invasive micropapillary carcinoma (IMPC) of the breast poses a high risk of locoregional recurrence, and postoperative radiotherapy (PORT) may be beneficial in IMPC. Hence, we determined the clinical value of PORT in IMPC patients. Patients and methods We assessed clinicopathological factors extracted from the Surveillance, Epidemiology, and End Results database (2004–2013). Univariate and multivariate Cox proportional hazards regressions were performed to assess the independent prognostic factors on breast cancer-specific survival (BCSS) and overall survival (OS). Results Of the 881 study patients, 444 (50.4%) and 437 (49.6%) underwent breast-conserving surgery (BCS) and mastectomy (MAST), respectively, of whom 357 (80.4%) and 153 (35.0%) underwent PORT, respectively. Patients with young age, large tumor size, or advanced nodal stage were more likely to undergo MAST and PORT compared with MAST alone. Patients with progesterone receptor-positive disease were more likely to receive BCS and PORT compared with BCS alone. The 5-year BCSS and OS were 95.7% and 90.9%, respectively. On multivariate analyses, tumor size, histological grade, and estrogen receptor status were independent predictors of BCSS and OS. The types of surgical procedures (MAST vs. BCS) were not an independent predictor of survival outcomes. Patients who underwent MAST with or without PORT had similar BCSS and OS in the multivariate analyses. Those who underwent BCS plus PORT did not have better BCSS and OS than those who underwent BCS alone. In the low-, intermediate-, and high-risk groups, PORT was not associated with better BCSS and OS than non-PORT groups in patients who received BCS or MAST. Conclusion IMPC has favorable BCSS and OS. Regardless of the types of surgical procedures (MAST or BCS), PORT groups were not inferior to non-PORT groups on BCSS and OS.
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Affiliation(s)
- San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen
| | - Wen-Wen Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou
| | - Jia-Yuan Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou
| | - Feng-Yan Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou
| | - Yong-Xiong Chen
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College, Xiamen University, Xiamen, People's Republic of China
| | - Zhen-Yu He
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou
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Onder S, Fayda M, Karanlık H, Bayram A, Şen F, Cabioglu N, Tuzlalı S, İlhan R, Yavuz E. Loss of ARID1A expression is associated with poor prognosis in invasive micropapillary carcinomas of the breast: A clinicopathologic and immunohistochemical study with long-term survival analysis. Breast J 2017; 23:638-646. [DOI: 10.1111/tbj.12823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Semen Onder
- Department of Pathology; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - Merdan Fayda
- Department of Radiation Oncology; Institute of Oncology; Istanbul University; Istanbul Turkey
| | - Hasan Karanlık
- Surgical Oncology Unit; Institute of Oncology; Istanbul University; Istanbul Turkey
| | - Aysel Bayram
- Department of Pathology; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - Fatma Şen
- Department of Medical Oncology; Institute of Oncology; Istanbul University; Istanbul Turkey
| | - Neslihan Cabioglu
- Department of General Surgery; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - Sıtkı Tuzlalı
- Department of Pathology; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - Rıdvan İlhan
- Department of Pathology; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - Ekrem Yavuz
- Department of Pathology; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
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Yang YL, Liu BB, Zhang X, Fu L. Invasive Micropapillary Carcinoma of the Breast: An Update. Arch Pathol Lab Med 2017; 140:799-805. [PMID: 27472238 DOI: 10.5858/arpa.2016-0040-ra] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT -Invasive micropapillary carcinoma (IMPC) is a distinct variant of mammary carcinoma in which tumor cells are arranged in morulelike clusters devoid of fibrovascular cores and situated within empty stromal spaces. Identification of IMPC can be achieved by the assessment of morphologic features in conjunction with the characteristic "inside-out" staining pattern of epithelial membrane antigen and sialyl Lewis X highlighted by immunohistochemical analysis. Although recognizing micropapillary architecture is often not challenging, the criteria for distinguishing between mixed and pure IMPC remain imprecise. Some mucin-producing carcinomas can also have micropapillary histology, but there is no consensus on whether these tumors are variants of IMPC or mucinous carcinomas. The molecular genetic studies demonstrate that IMPCs have distinct molecular genetic profiles, supporting the theory that they constitute distinct pathologic entities. However, genomic analyses have not identified any specific genomic aberration that may explain the distinctive morphology and clinical behavior of IMPC. OBJECTIVE -To provide an overview on the current concepts in the diagnosis and pathogenesis of IMPC of the breast, incorporating recent molecular genetic advances and prognosis-based reclassification. DATA SOURCES -PubMed search and the cited references were reviewed. CONCLUSIONS -The recent evolution of prognosis-based reclassification and molecular genetic advances has enhanced our knowledge of the pathogenesis of IMPC of the breast. Additional studies might reveal consistent molecular alterations that underlie the formation of the inside-out growth pattern, and they might elucidate the molecular mechanisms responsible for the unfavorable clinical behavior of IMPC.
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Affiliation(s)
| | | | | | - Li Fu
- From the Department of Breast Pathology and Research Laboratory, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China (Drs Yang, Liu, and Fu); and the Department of Pathology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey (Dr Zhang). Drs Zhang and Fu jointly supervised the work
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Li G, Yang S, Yao J, Wang Z, Yao G, Liu M, Ye C. Invasive micropapillary carcinoma of the breast had poor clinical characteristics but showed no difference in prognosis compared with invasive ductal carcinoma. World J Surg Oncol 2016; 14:207. [PMID: 27492008 PMCID: PMC4974796 DOI: 10.1186/s12957-016-0960-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/23/2016] [Indexed: 12/19/2022] Open
Abstract
Background It is controversial for prognosis of invasive micropapillary carcinoma (IMPC) compared with invasive ductal carcinoma (IDC) of the breast. To better understand the difference between IMPC and IDC prognoses, we conducted this retrospective study. Methods Data from 33 patients with IMPC were retrospectively reviewed, and the clinicopathologic characteristics and survival status were compared with those of 347 patients with IDC who were treated during the same period. Results The IMPC cases were of larger tumor size, greater proportion of nodal involvement, and an increased incidence of lymphovascular invasion compared with IDC cases. The overall survival (OS), local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and failure-free survival (FFS) rates were not significantly different between IMPC and IDC. The 3-year OS rate was 97 vs 94.2 % for the IMPC and IDC patients, respectively. The 3-year FFS rate was 87.9 vs 86.2 % for the IMPC and IDC patients, respectively. For IMPC patients, the 3-year LRFS rate was 93.9 % and in IDC patients was 89.0 %. The 3-year DMFS rates of IMPC patients was 90.9 % and IDC patients was 89 %. Conclusions IMPC had poor clinical characteristics, but it showed no difference in OS, FFS, LRFS, and DMFS compare with IDC.
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Affiliation(s)
- Guanqiao Li
- Breast Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.,Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, 570311, People's Republic of China
| | - Shiping Yang
- Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, People's Republic of China
| | - Jia Yao
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, 570311, People's Republic of China
| | - Zhenping Wang
- Department of Radiology, Hainan Province People's Hospital, Haikou, Hainan, 570311, People's Republic of China
| | - Guangyu Yao
- Breast Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Mingfeng Liu
- Breast Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Changsheng Ye
- Breast Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.
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Agoumi M, Giambattista J, Hayes MM. Practical Considerations in Breast Papillary Lesions: A Review of the Literature. Arch Pathol Lab Med 2016; 140:770-90. [DOI: 10.5858/arpa.2015-0525-ra] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—Diagnosis of papillary breast lesions, especially in core biopsies, is challenging for most pathologists, and these lesions pose problems for patient management. Distinction between benign, premalignant, and malignant components of papillary lesions is challenging, and the diagnosis of invasion is problematic in lesions that have circumscribed margins. Obtaining a balance between overtreatment and undertreatment of these lesions is also challenging.
Objectives.—To provide a classification and a description of the histologic and immunohistochemical features and the differential diagnosis of papillary breast lesions, to provide an update on the molecular pathology of papillary breast lesions, and to discuss the recommendations for further investigation and management of papillary breast lesions. This review provides a concise description of the histologic and immunohistochemical features of the different papillary lesions of the breast.
Data Sources.—The standard pathology text books on breast pathology and literature on papillary breast lesions were reviewed with the assistance of the PubMed database (http://www.ncbi.nlm.nih.gov/pubmed).
Conclusions.—Knowledge of the clinical presentation, histology, immunoprofile, and behavior of papillary breast lesions will assist pathologists with the diagnosis and optimal management of patients with papillary breast lesions.
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Affiliation(s)
| | | | - Malcolm M. Hayes
- From the Department of Pathology, DynaLIFEDx Diagnostic Laboratory Services, Edmonton, Alberta, Canada (Dr Agoumi); the Departments of Pathology (Drs Agoumi and Hayes) and Radiation Oncology (Dr Giambattista), British Columbia Cancer Agency, Vancouver, Canada; and the Department of Pathology, University of British Columbia, Vancouver (Dr Hayes)
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Over-expression of NOTCH1 as a biomarker for invasive breast ductal carcinoma. 3 Biotech 2016; 6:58. [PMID: 28330128 PMCID: PMC4752955 DOI: 10.1007/s13205-016-0373-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 09/10/2015] [Indexed: 12/17/2022] Open
Abstract
Breast cancer is the leading cause of cancer-related death in women worldwide. Invasive ductal carcinoma (IDC) is the most frequent invasive form of breast cancer followed by metastasis. There is no accepted marker for distinguishing this form from other less aggressive forms of breast cancer. Therefore, finding new markers especially molecularly detectable ones are noteworthy. It has been shown that NOTCH1 has been overexpressed in the patients with breast cancer, but no study has investigated the expression of NOTCH1 and its correlation with other molecular and hormonal markers of breast cancer so far. In the current study, 20 breast cancer tissues and 20 matched adjacent normal breast tissue from breast cancer patients were obtained and categorized in two groups: patients with IDC and patient with other types of breast cancer. Gene expression analysis using real-time PCR showed that the NOTCH1 gene was significantly overexpressed in patients with IDC. We also found a slight correlation between NOTCH1 overexpression and p53 accumulation in the cancerous cells confirmed by Immunohistochemistry (IHC). This results showed that it is possible to introduce NOTCH1 expression as a novel biomarker of IDC, alone or preferably accompanied by IHC of p53. We also can design new therapeutic agents targeting NOTCH1 expression for inhibition of metastasis in ductal breast carcinoma.
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Gruel N, Fuhrmann L, Lodillinsky C, Benhamo V, Mariani O, Cédenot A, Arnould L, Macgrogan G, Sastre-Garau X, Chavrier P, Delattre O, Vincent-Salomon A. LIN7A is a major determinant of cell-polarity defects in breast carcinomas. Breast Cancer Res 2016; 18:23. [PMID: 26887652 PMCID: PMC4756502 DOI: 10.1186/s13058-016-0680-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 01/29/2016] [Indexed: 11/10/2022] Open
Abstract
Background Polarity defects are a hallmark of most carcinomas. Cells from invasive micropapillary carcinomas (IMPCs) of the breast are characterized by a striking cell polarity inversion and represent an interesting model for the analysis of polarity abnormalities. Methods In-depth investigation of polarity proteins in 24 IMPCs and a gene expression profiling, comparing IMPC (n = 73) with invasive carcinomas of no special type (ICNST) (n = 51) have been performed. Results IMPCs showed a profound disorganization of the investigated polarity proteins and revealed major abnormalities in their subcellular localization. Gene expression profiling experiments highlighted a number of deregulated genes in the IMPCs that have a role in apico-basal polarity, adhesion and migration. LIN7A, a Crumbs-complex polarity gene, was one of the most differentially over-expressed genes in the IMPCs. Upon LIN7A over-expression, we observed hyperproliferation, invasion and a complete absence of lumen formation, revealing strong polarity defects. Conclusion This study therefore shows that LIN7A has a crucial role in the polarity abnormalities associated with breast carcinogenesis. Electronic supplementary material The online version of this article (doi:10.1186/s13058-016-0680-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nadège Gruel
- Institut Curie, PSL Research University, INSERM U830, 26 rue d'Ulm, 75248, Paris cédex 05, France. .,Département de Recherche Translationnelle, Institut Curie, PSL Research University, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Laetitia Fuhrmann
- Institut Curie, PSL Research University, CNRS UMR144, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Catalina Lodillinsky
- Institut Curie, PSL Research University, CNRS UMR144, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Vanessa Benhamo
- Institut Curie, PSL Research University, INSERM U830, 26 rue d'Ulm, 75248, Paris cédex 05, France. .,Département de Recherche Translationnelle, Institut Curie, PSL Research University, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Odette Mariani
- Department of Pathology, Institut Curie, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Aurélie Cédenot
- Department of Pathology, Institut Curie, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Laurent Arnould
- Département de Pathologie and Centre de Ressources Biologiques Ferdinand Cabanne, Centre Georges François Leclerc, 1 rue Professeur Marion, BP 77980, 21079, Dijon cédex, France.
| | - Gaëtan Macgrogan
- Institut Bergonié, Service de Biopathologie, 229 cours de l'Argonne, 33076, Bordeaux, France.
| | - Xavier Sastre-Garau
- Department of Pathology, Institut Curie, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Philippe Chavrier
- Institut Curie, PSL Research University, CNRS UMR144, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Olivier Delattre
- Institut Curie, PSL Research University, INSERM U830, 26 rue d'Ulm, 75248, Paris cédex 05, France.
| | - Anne Vincent-Salomon
- Institut Curie, PSL Research University, INSERM U830, 26 rue d'Ulm, 75248, Paris cédex 05, France. .,Department of Pathology, Institut Curie, 26 rue d'Ulm, 75248, Paris cédex 05, France.
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Rakha EA. Morphogenesis of the papillary lesions of the breast: phenotypic observation. J Clin Pathol 2015; 69:64-9. [DOI: 10.1136/jclinpath-2015-203191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 07/05/2015] [Indexed: 01/18/2023]
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50
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Kurebayashi J, Miyoshi Y, Ishikawa T, Saji S, Sugie T, Suzuki T, Takahashi S, Nozaki M, Yamashita H, Tokuda Y, Nakamura S. Clinicopathological characteristics of breast cancer and trends in the management of breast cancer patients in Japan: Based on the Breast Cancer Registry of the Japanese Breast Cancer Society between 2004 and 2011. Breast Cancer 2015; 22:235-44. [PMID: 25758809 DOI: 10.1007/s12282-015-0599-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 02/25/2015] [Indexed: 01/15/2023]
Abstract
PURPOSES We conducted a study to analyze the clinicopathological characteristics of breast cancer in Japan registered to the Japanese Breast Cancer Registry of the Japanese Breast Cancer Society (JBCS). Trends in the management of breast cancer patients in Japan were also analyzed. PATIENTS AND METHODS More than 250,000 breast cancer patients were registered to the JBCS registry between 2004 and 2011. Demographic and clinicopathological factors in newly diagnosed primary breast cancer patients were registered to the JBCS through the Web-based system from affiliated institutes nationwide. RESULTS Two distinct peaks were observed, in patients in their late 40s and early 60s, in the population-adjusted age distribution of breast cancer patients. An increased rate of screen-detected breast cancer may contribute to an earlier detection of breast cancer and increased rate of non-invasive ductal carcinoma. The positive rate of either ER or PgR appears to have increased in recent years. The annual rates of patients treated with breast-conserving surgery increased until 2006, but these increases stopped in 2007 and thereafter plateaued at approximately 60 %. The annual rates of patients treated with sentinel lymph node dissection alone have steadily increased. The annual rates of patients treated with preoperative trastuzumab plus chemotherapy have also increased, as well as those treated with postoperative aromatase inhibitors. The annual rates of patients treated with postoperative anthracycline-containing regimens have decreased, whereas those treated with postoperative taxane-containing regimens have increased. The postoperative use of trastuzumab has markedly increased since 2007. CONCLUSION Although this study was based on the registry database, several unique clinicopathological characteristics of breast cancer in Japan have been unveiled. Our results suggest that recent trends in the management of breast cancer patients in Japan were strongly followed by clinical evidence that originated from a number of clinical trials worldwide.
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Affiliation(s)
- Junichi Kurebayashi
- Department of Breast and Thyroid Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan,
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