Analysis About The Prognostic Factors Of Invasive Micropapillary Carcinoma Of The Breast

Research Background and Objective Invasive micropapillary carcinoma(IMPC)is a rare and special type of breast cancer.It has a high degree of malignancy,strong invasiveness,a high rate of local recurrence and metastasis,and a poor prognosis.Pure IMPC is extremely rare.And most of them are mixed IMPC,that is combined with other types of breast cancer.The most common component of the mixed IMPC is invasive ductal carcinoma(IDC).At present,it is generally believed that invasive micropapillary carcinoma of the breast is an invasive tumor with poor prognosis,and has high lymphatic invasion rate and lymph node metastasis rate.However,there are few related studies because of it’s low incidence,and its biological characteristicsr is still unclear now.The purpose of this research is to analyze the clinical pathological features and prognostic factors of invasive micropapillary carcinoma of the breast.Method A retrospective study was used in this study to analyze primary invasive micropapillary carcinoma of the breast(n=43)diagnosed and treated in our hospital between June 2009 to December 2016,and relevant clinical and pathological data were collected and followed up.Result A total of 43 cases of invasive micropapillary carcinoma of the breast were included in this study and all were female patients.The median follow-up time was3.5 years.There were 7 cases of pure IMPC,accounting for 16.3%,and 36 cases of mixed IMPC,accounting for 83.7%.Two of the 43 patients had distant metastases at the time of their first visit,and 12 cases had disease progression during the follow-up period.And there were 8 deaths due to the disease.There were 33 cases(76.7%)of ER positive cases and 10 cases(23.3%)of ER negative cases.PR was positive in 26 cases(60.5%)and negative in 17 cases(39.5%).HER2 positive in 15 cases(34.9%),and HER2 negative in 28 cases(65.1%).There were 26 cases(60.5%)in Ki67≥14%,and 17 cases(39.5%)in Ki67<14%.There were 14 cases(32.6%)of Luminal A type,20 cases(46.5%)of Luminal B type,7 cases(16.3%)of HER2 overexpression type,and 2 cases(4.6%)of triple negative type.About clinical stage,there was 3 cases(6.9%)in TNM I period,23cases(53.5%)in TNM stage II,15 cases(34.9%)in TNM stage III,and 2cases(4.7%)in TNM stage IV.In all 43 cases,there were 35 cases of axillary lymph node metastases,and the metastasis rate was 81.4%.Among them,there were 21 patients with 1-3 lymph node metastatic carcinomas,and 14 patients with 4 or more lymph node metastatic carcinomas.According to the IMPC intragroup analysis,the OS and DFS of ER positive,PR positive,and Her2 negative patients were higher than those of ER negative,PR negative,and Her2 positive patients.Patients with Luminal A had higher OS and DFS than those with HER2 overexpression.Patients with Luminal B had higher OS and DFS than those with HER2 overexpression.COX multivariate analysis showed that TNM staging was an independent prognostic factor affecting the overall survival rate of patients with invasive micropapillary carcinoma of the breast.Conclusion1.Invasive micropapillary carcinoma(IMPC)of the breast is a special type of breast cancer with a low incidence of disease,and the type of mixed IMPC is more common,but there is no clear correlation of their prognosis between pure or mixed type of IMPC.2.There were significant differences in the OS and DFS between the expression of ER,PR,HER2 and different molecular typing in IMPC patients(P<0.05).Differences in OS between patients with different TNM staging were statistically significant(P=0.003).The age of onset,menstrual status,tumor location,and surgical methods have nothing to do with the overall survival of patients.3.The lymph node metastasis rate of patients with IMPC is high,and it has strong lymphocytic properties.4.TNM stage is an independent prognostic factor affecting the overallsurvival time of breast invasive micropapillary carcinoma(P=0.047).And we believe that the earlier the stage is,the better prognosis the patient get.