Invasive Micropapillary Carcinoma of the Breast : Association of Pathologic Features With Lymph Node Metastasis

Department of Breast Cancer Pathology and Research Laboratory, State Key Laboratory of Breast Cancer Research, Cancer Hospital of Tianjin Medical University, Tianjin, China.
American Journal of Clinical Pathology (Impact Factor: 3.01). 12/2006; 126(5):740-6. DOI: 10.1309/AXYY-4AJT-MNW6-FRMW
Source: PubMed

ABSTRACT Invasive micropapillary carcinoma (IMPC) of the breast is characterized by a high incidence of axillary lymph node metastasis. To investigate the relationship between pathologic features and lymph node metastasis, 51 cases of breast carcinoma with IMPC components were studied. Immunohistochemical analysis for vascular endothelial growth factor (VEGF)-C and VEGF receptor (VEGFR)-3 was performed, and lymphatic vessel density was measured. The main findings included a significantly increased number of positive lymph nodes and/or an increased rate of lymph node metastasis in IMPC with a higher histologic grade, prominent stromal infiltration of lymphocytes, and higher VEGF-C expression and lymphatic vessel density. The percentage of IMPC component in the tumor was not associated with the incidence of lymph node metastasis. The results suggest that the histologic grade, lymphatic vessel density, and lymphocyte infiltration of IMPC are the key factors that influence lymph node metastasis. Further studies are required to elucidate the mechanisms underlying the lymphotropism of this distinct variant of breast carcinoma.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Breast invasive micropapillary carcinoma (IMPC) is a rare subtype of breast cancer with a high potential of lymph node metastasis, aggressive clinical behavior, and poor disease-free or overall survival. Expression of leucine zipper putative tumor suppressor 1 (LZTS1) was frequently lost or reduced in breast cancer tissues. This study investigated the expression of LZTS1 protein in breast IMPC tissues using immunohistochemistry. In addition, somatic LZTS1 mutations and promoter methylation were assessed to determine an association with clinicopathological data from IMPC patients. LZTS1 protein was downregulated in 62 (62 %) of 100 IMPC tissue samples and was significantly associated with lymph node metastasis (P < 0.05). A LZTS1 exon mutation occurred in one of the 53 IMPC cases analyzed, whereas a LZTS1 intron mutation occurred in 26 of 53 cases. Moreover, LZTS1 promoter was frequently methylated in IMPC samples and was associated with reduced LZTS1 expression levels in IMPC tissues. These data demonstrated that the loss of LZTS1 expression was associated with lymph node metastasis in patients with IMPC, and LZTS1 promoter methylation could be responsible for the loss of LZTS1 expression.
    Pathology & Oncology Research 03/2015; DOI:10.1007/s12253-015-9923-x · 1.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose The purpose of this study is to evaluate imaging and histopathologic findings including the immunohistochemical characteristics of invasive micropapillary carcinoma (IMPC) of the breast. Methods Twenty-nine patients diagnosed with IMPC were included in the present study. Mammographic, sonographic, and magnetic resonance imaging (MRI) findings were analyzed retrospectively according to the American College of Radiology Breast Imaging Reporting and Data System lexicon. 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) findings were also evaluated. Microscopic slides of surgical specimens were reviewed in consensus by two pathologists with a specialty in breast pathology. Results Most IMPCs presented as a high density irregular mass with a non-circumscribed margin associated with microcalcifications on mammography, as an irregular hypoechoic mass with a spiculated margin on ultrasound, and as irregular spiculated masses with washout patterns on MRI. PET-CT showed a high maximum standardized uptake value (SUVmax) (mean, 11.2). Axillary nodal metastases were identified in 65.5% of the patients. Immunohistochemical studies showed high positivities for estrogen receptor and c-erbB-2 (93.1% and 51.7µ, respectively). Conclusion Even though the imaging characteristics of IMPCs are not distinguishable from typical invasive ductal carcinomas, this tumor type frequently results in nodal metastases and high positivities for both estrogen receptor and c-erbB-2. The high SUVmax value that is apparent on PET-CT might be helpful in the diagnosis of IMPC.
    Journal of Breast Cancer 03/2012; 15(1):57. DOI:10.4048/jbc.2012.15.1.57 · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In order to understand invasive/adhesive and drug resistant properties of intratumor morphological heterogeneity of breast cancer, we compared the expression of genes responsible for the cell adhesion and for the drug resistance between distinct morphological structures of breast tumors. Tubular (hollow-like), alveolar (morula-like), trabecular, solid structures/patterns, and discrete (small) groups of tumor cells were isolated from invasive carcinoma of no special type (n=3) and invasive micropapillary carcinoma (n=1) of the breast using laser microdissection. The gene expression of cadherins, catenins, integrins, ABC transporters, GSTP1, and drug targets was analyzed using qRT-PCR. Expression of catenin genes was identified in almost all structures. In contrast, the expression of cadherin and integrin genes significantly varied depending on the morphological variant. Cadherin expression declined in the row: solid – alveolar and trabecular structures – discrete groups of tumor cells. Expression of integrins declined in the row: solid and alveolar – trabecular structures – discrete groups of tumor cells. For drug resistance genes, trabecular structures more often demonstrated activity of genes coding for ABC transporters compared to other morphological variants. These results indicate that intratumoral morphological heterogeneity in breast cancer correlates with expression profile of adhesion and drug resistance genes reflecting different patterns of invasive growth and responsiveness to chemotherapy.
    Neoplasma 02/2015; DOI:10.4149/neo_2015_041 · 1.64 Impact Factor


Available from