Invasive micropapillary carcinoma of the breast - Clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior
Invasive micropapillary carcinoma of the breast - Clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior
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DOI：
10.1309/xtj7vhb49ud78x60
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发表时间：
2004-06-01
影响因子：
3.5
通讯作者：
Petrella, G
中科院分区：
文献类型：
--
作者：
Pettinato, G;Manivel, CJ;Petrella, G
我们报告了62例乳腺浸润性微乳头状癌，其特征是脆弱的假乳头状结构缺乏纤维血管核心和管状肺泡结构自由漂浮在明确的，空的空间。除我之外，所有患者均为女性（中位年龄57岁，范围25-89岁）。肿瘤大小范围为0.7 - 10 cm（中位数，2.8 cm）; 54例（87%）为3级。29例（47%）发现沙瘤体。39例（63%）存在局灶性至大量淋巴管渗透。淋巴结转移、真皮增生和复发灶的结构特征得以保留。五十六例患者（90%）有转移性腋窝淋巴结：18例肿瘤雌激素受体阳性（32%）; 11例孕激素受体阳性（20%）; 53例（95%）HER 2/neu过表达，39例（70%）p53过表达。一个特殊的免疫反应MUC 1限于细胞质膜朝向基质和E-钙粘蛋白的免疫反应性的情况下，在细胞质膜的同一侧表示反转的细胞极化和细胞粘附分子的干扰。在41例随访患者中，29例（71%）局部复发（平均30个月），20例（49%）死于疾病。这些结果强调了这种乳腺癌变异的侵袭行为和不良预后。应考虑积极的术前新辅助化疗。
We report 62 cases of invasive micropapillary carcinoma of the breast characterized by delicate pseudopapillary structures lacking a fibrovascular core and by tubuloalveolar structures freely floating in clear, empty spaces. All patients but I were women (median age, 57 years; range, 25-89 years). Tumor size ranged from 0.7 to 10 cm (median, 2.8 cm); 54 (87%) were grade 3. Psammoma bodies were identified in 29 (47%). Focal to massive lymphatic permeation was present in 39 (63%). Architectural features were retained in the node metastases, dermal lymphatics, and recurrences. Fifty-six patients (90%) had metastatic axillary nodes: 18 tumors were estrogen receptor-positive (32%); 11 were progesterone receptor-positive (20%); HER2/neu was overexpressed in 53 (95%) and p53 in 39 (70%). A peculiar immunoreactivity for MUC1 limited to the cytoplasmic membrane oriented toward the stroma and an absence of immunoreactivity for E-cadherin in the same side of the cytoplasmic membrane indicated inversion of cell polarization and a disturbance in the cell adhesion molecules. Of 41 patients with available follow-up, 29 (71%) had local recurrence (mean, 30 months) and 20 (49%) died of disease. These results underscore the aggressive behavior and poor prognosis of this breast carcinoma variant. Aggressive preoperative neoadjuvant chemotherapy should be considered.