J Pathol Transl Med.  2017 Jul;51(4):403-409. 10.4132/jptm.2017.03.18.

Prognostic Significance of a Micropapillary Pattern in Pure Mucinous Carcinoma of the Breast: Comparative Analysis with Micropapillary Carcinoma

• Kim HJ
• Park K
• Kim JY
• Kang G
• Gwak G
• Park I

• KMID: 2392581
• DOI: http://doi.org/10.4132/jptm.2017.03.18

Abstract

BACKGROUND
Mucinous carcinoma of the breast is an indolent tumors with a favorable prognosis; however, micropapillary features tend to lead to aggressive behavior. Thus, mucinous carcinoma and micropapillary carcinoma exhibit contrasting biologic behaviors. Here, we review invasive mucinous carcinoma with a focus on micropapillary features and correlations with clinicopathological factors.
METHODS
A total of 64 patients with invasive breast cancer with mucinous or micropapillary features were enrolled in the study. Of 36 pure mucinous carcinomas, 17 (47.2%) had micropapillary features and were termed mucinous carcinoma with micropapillary features (MUMPC), and 19 (52.8%) had no micropapillary features and were termed mucinous carcinoma without micropapillary features. MUMPC were compared with 15 invasive micropapillary carcinomas (IMPC) and 13 invasive ductal and micropapillary carcinomas (IDMPC).
RESULTS
The clinicopathological factors of pure mucinous carcinoma and MUMPC were not significantly different. In contrast to IMPC and IDMPC, MUMPC had a low nuclear grade, lower mitotic rate, higher expression of hormone receptors, negative human epidermal growth factor receptor 2 (HER2) status, lower Ki-67 proliferating index, and less frequent lymph node metastasis (p < .05). According to univariate analyses, progesterone receptor, HER2, T-stage, and lymph node metastasis were significant risk factors for overall survival; however, only T-stage remained significant in a multivariate analysis (p < .05).
CONCLUSIONS
In contrast to IMPC and IDMPC, the micropapillary pattern in mucinous carcinoma does not contribute to aggressive behavior. However, further analysis of a larger series of patients is required to clarify the prognostic significance of micropapillary patterns in mucinous carcinoma of the breast.

Keyword

Breast; Micropapillary; Mucinous; Prognosis

MeSH Terms

Adenocarcinoma, Mucinous*
Breast Neoplasms
Breast*
Humans
Lymph Nodes
Mucins*
Multivariate Analysis
Neoplasm Metastasis
Prognosis
Receptor, Epidermal Growth Factor
Receptors, Progesterone
Risk Factors
Mucins
Receptor, Epidermal Growth Factor
Receptors, Progesterone

Figure

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  Fig. 1. Micropapillary features were found in more than 50% of the mucinous carcinoma cases.

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