Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis

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.

Neuroendocrine tumor of the breast showing invasive micropapillary features and multiple lymph node metastases

“…Furthermore, multivariate analyses have revealed that, in patients with NENs of the breast, overall survival can be predicted by tumor size, lymph node status, and the MIB‐1 proliferation rate 10 . On the other hand, “micropapillary structure” of neoplastic cells in the stromal tissue, regardless of the proportion of its component or the original site, is associated with an affinity for lymphatic vessels, resulting in a high prevalence of nodal involvement 11–14 . Our present patient with an unusual breast cancer showing both invasive micropapillary and neuroendocrine features developed plural lymphoglandular metastases as well as having a tumor with a large diameter and luminal B‐like immuno‐profile.…”

“…10 On the other hand, "micropapillary structure" of neoplastic cells in the stromal tissue, regardless of the proportion of its component or the original site, is associated with an affinity for lymphatic vessels, resulting in a high prevalence of nodal involvement. [11][12][13][14] Our present patient with an unusual breast cancer showing both invasive micropapillary and neuroendocrine features developed plural lymphoglandular metastases as well as having a tumor with a large diameter and luminal B-like immuno-profile. Accordingly, meticulous clinical follow-up continues to be essential for this case.…”

An Update on Tissue Contraction in Immediate Breast Reconstruction Using an Adjustable Implant Partially Filled With Air

“…It is noted to have a higher histological grade and rate of lymph node metastasis. Furthermore, micropapillary carcinomas have larger tumors, which presents an oncological and surgical challenge [ 13 , 14 ].…”

Mammographically Occult Invasive Lobular Carcinoma With Intradermal Invasion

“…Invasive micropapillary carcinoma (IMPC) is a rare histological subtype of carcinoma that is associated with its difficulty in accurate imaging estimation. It is often associated with larger tumors and a higher percentage of positive lymph nodes due to well-recognized lymphovascular tropism [ 10 ]. Given the patient’s palpable 2-cm lesion and lack of positive lymph nodes, this was not considered.…”