|LETTER TO THE EDITOR
|Year : 2014 | Volume
| Issue : 4 | Page : 576
Pure micropapillary carcinoma of breast: A quite rare subtype
A Oguz1, F Aykas2, FC Kaya3, D Unal4, A Tasdemir3
1 Department of Medical Oncology, Baskent University, Ankara, Turkey
2 Internal Medicine Department, Kayseri Education and Research Hospital, Kayseri, Turkey
3 Pathology Department, Kayseri Education and Research Hospital, Kayseri, Turkey
4 Radiation Oncology Department, Kayseri Education and Research Hospital, Kayseri, Turkey
|Date of Web Publication||1-Feb-2016|
Dr. A Oguz
Department of Medical Oncology, Baskent University, Ankara
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Oguz A, Aykas F, Kaya F C, Unal D, Tasdemir A. Pure micropapillary carcinoma of breast: A quite rare subtype. Indian J Cancer 2014;51:576
Invasive micropapillary breast cancer (IMBC) is an aggressive type of typical invasive ductal carcinoma, which exhibits a unique and characteristic growth pattern. Usually, IMBC is presented as mixed-in with invasive ductal carcinoma or ductal carcinoma in situ, with the relative amount of the "micropapillary component" ranging from 20% to 80% of the total tumor mass. Here, a case of pure IMBC with a relatively better outcome is presented.
An 83-year-old woman admitted with a complaint of a left breast mass involving the skin. Modified radical mastectomy and axillary dissection was performed. Microscopically, the tumor was composed of clusters of cohesive tumor cells with hyperchromatic nuclei and large eosinophilic cytoplasm, within quite prominent "clear spaces," resembling dilated angiolymphatic vessels [Figure 1]. The tumor was attacking epidermal layer in some areas [Figure 2]. A total of 8 lymph nodes were dissected and all were metastatic. Immunohistochemically, the tumor stained positive for estrogen receptor and progesterone receptor and negative for cerbB2 and thyroid transcription factor-1. Ki-67 proliferation index was detected as 20%. With a diagnosis of pT4bN2M0 pure micropapillary breast carcinoma, adjuvant chemotherapy plan of 4 cycles of cyclophosphamide + doxorubisin followed by weekly paclitaxel was administered to the patient. She is still disease free on the 16th month of diagnosis and taking hormonotherapy.
The histologic structure of ınvasive micropapillary carcinoma is strikingly presented as mixed-in with invasive ductal carcinoma or ductal carcinoma in situ. However pure IMBC as in this case, is reported to be quite rare. There are limited data about prognosis and survival rates of pure IMBC. Luna-Moré et al. has reported that 5 year survival was detected in 60% of cases of breast cancer with micropapillary components. Paterakos et al. compared 21 IMBC cases with the classical invasive breast carcinoma cases and reported similar clinical course, disease free and overall survival in between two groups. Nassar et al. have shown that, breast cancer cases with higher rates of micropapillary component present a worse clinical course because of higher rates of skin and axillary involvement. However, when cases with same N stage at diagnosis were compared, overall survival has been reported to be similar also for those harboring higher papillary component. These survival values all belong to cases of invasive breast cancer with different rates of micropapillary involvement, but exact outcomes for pure cases are still inconclusive because of rarity of the entity.
| » References|| |
Erhan Y, Erhan Y, Zekioğlu O. Pure invasive micropapillary carcinoma of the male breast: Report of a rare case. Can J Surg 2005;48:156-7.
Luna-Moré S, de los Santos F, Bretón JJ, Cañadas MA. Estrogen and progesterone receptors, c-erbB-2, p53, and Bcl-2 in thirty-three invasive micropapillary breast carcinomas. Pathol Res Pract 1996;192:27-32.
Paterakos M, Watkin WG, Edgerton SM, Moore DH 2nd
, Thor AD. Invasive micropapillary carcinoma of the breast: A prognostic study. Hum Pathol 1999;30:1459-63.
Nassar H, Wallis T, Andea A, Dey J, Adsay V, Visscher D. Clinicopathologic analysis of invasive micropapillary differentiation in breast carcinoma. Mod Pathol 2001;14:836-41.
[Figure 1], [Figure 2]