The Breast
Volume 19, Issue 3 , Pages 231-237, June 2010

Differences in prognostic factors and patterns of failure between invasive micropapillary carcinoma and invasive ductal carcinoma of the breast: Matched case–control study

  • Jeong Il Yu

      Affiliations

    • Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea
  • ,
  • Doo Ho Choi

      Affiliations

    • Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea
    • Corresponding Author InformationCorresponding author. Tel.: +82 2 3410 2436; fax: +82 2 3410 2619.
  • ,
  • Won Park

      Affiliations

    • Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea
  • ,
  • Seung Jae Huh

      Affiliations

    • Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea
  • ,
  • Eun Yoon Cho

      Affiliations

    • Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  • ,
  • Young Hyuk Lim

      Affiliations

    • Department of Hematology–Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  • ,
  • Jin Suk Ahn

      Affiliations

    • Department of Hematology–Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  • ,
  • Jung Hyun Yang

      Affiliations

    • Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  • ,
  • Suk Jin Nam

      Affiliations

    • Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Received 21 October 2009; received in revised form 25 January 2010; accepted 27 January 2010. published online 22 March 2010.

Abstract 

Purpose

We designed this study to identify differences in prognostic factors and patterns of failure between invasive micropapillary carcinoma (IMPC) and invasive ductal carcinoma (IDC) in patients with breast cancer.

Experimental design

We identified 72 cases of IMPC who were diagnosed between 1999 and 2007 at the Samsung Medical Center. These patients were matched with 144 controls who were diagnosed with IDC during the same period. Exact matches were made for age (±3 years), pathologic tumour and node stage, and treatment methods (surgery and radiation therapy).

Results

The median follow-up period was 45 months (13–116) for IMPC and 50 months (16–122) for IDC. Lymphovascular invasion (LVI, p<0.0001), axillary lymph node extracapsular extension (ECE, p=0.001) and high nuclear grade (p=0.032) were more frequently detected in patients with IMPC. During the follow-up period, treatment failed in 15 IMPC patients (20.8%) and in 26 IDC patients (18.1%). Loco-regional recurrences developed in 11 IMPC patients (15.3%) and eight IDC patients (5.6%). Importantly, of 57 IMPC patients who had positive axillary nodes, seven patients (12.3%) had axilla and/or supraclavicular recurrence. Therefore, at 5 years, the loco-regional recurrence-free survival was 79.1% in the IMPC patients vs. 93.3% in the IDC patients (p=0.0024).

Conclusion

Our study showed that IMPC is associated with LVI, ECE, high nuclear grade, and a greater degree of loco-regional recurrence, especially in the axilla and supraclavicular areas. Therefore, axillary and supraclavicular radiation therapy should be considered in IMPC patients with axillary node metastasis.

Keywords: Invasive micropapillary carcinoma, Patterns of failure, Case–control study

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PII: S0960-9776(10)00037-8

doi:10.1016/j.breast.2010.01.020

The Breast
Volume 19, Issue 3 , Pages 231-237, June 2010