| Objective:Invasive micropapillary Carcinoma(IMPC),as a special type of invasive breast cancer,accounts for 2.6%-6.0% of the incidence of breast cancer.Its low morbidity makes it difficult to analyze the differences of clinical prognosis and pathological characteristics.Treatment is generally based on breast cancer routine treatment norms and physicians’ clinical experience.Previous literature reports different conclusions about the relationship between the proportion of breast IMPC components and the prognosis of patients.The purpose of this study was to analyze the clinicopathologic data and prognosis of IMPC patients in order to provide help for clinical diagnosis and treatment.Methods:1.This study was a single-center retrospective study of clinicopathological data and follow-up data of 246 patients with IMPC who were treated at our Hospital from January 2011 to December 2015.By telephone or reading follow-up outpatient review,we record patients’ the most recent review situation(such as: imaging data)and follow-up endocrine therapy.Follow-up as at 1 July 2019.2.The immunohisto-tochemistry(IHC)was used to evaluate the expression of estrogen(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2)and other markers.The positive rate of tumor cell nuclear staining> 1% diagnosed ER and PR positive.HER2(-)accouts for the IHC of HER2 staining 0,1 + and 2+ plus FISH(-);HER2(+)accouts for 2+ plus FISH(+)and the IHC of HER2 staining 3 +.3.The data were analyzed by SPSS 24.0(SPSS,INC,CHICAGO,IL,USA).The Chi-square test was used to compare the clinicopathological data;the mean was compared by t-test;the mean was compared by t-test.The Cox proportional hazard models was used to analyze the multivariate factors of prognosis.The log-rank test and Kaplan-Meier method were used to analyze the differences between OS and DFS.P< 0.05 was considered statistically significant.Results:1.Multivariate analysis of Cox Proportional Hazard model showed that IMPC patients with positive HER-2 expression,metastasis of 4 or more lymph nodes,and nipple invasion had a better prognosis than those with negative expression of HER-2,metastasis of less than 4 lymph nodes,and no nipple invasion.Nipple invasion is an independent risk factor for OS in patients with breast IMPC.2.The 5-year DFS and OS of 246 patients with IMPC were 79.6% and 78.2%respectively.The 5-year DFS rate of A group(76.5%)was lower than that of group B(83.6%),and the 5-year Os rate of A group(74.1%)was significantly lower than that of group B(81.6%).3.Among 246 patients,DFS(χ2 = 5.219,P = 0.022)and OS(χ2 = 3.963,P = 0.047)were lower than those without radiotherapy.Among the patients with nipple invasion,DFS(χ2 = 6.541,P = 0.011)and OS(χ2 = 6.455,P = 0.012)were lower in those without radiotherapy.Among the patients in group A,DFS(χ2 = 6.566,P = 0.010)and OS(χ2 = 5.263,P = 0.022)were lower in those without radiotherapy.4.There was no significant difference in DFS among the 246 patients who received endocrine therapy and those who did not,but there was significant difference in Os(p0.039).Conclusions:1.Breast IMPC,as a special type of breast cancer with low incidence,has the characteristics of high lymph node metastasis rate and high recurrence rate.Nipple invasion suggests a poor prognosis.2.The proportion of breast IMPC components> 50% indicates that the prognosis is poor and should be brought to clinical attention.3.Radiotherapy can control local recurrence and prolong patient survival.For patients with IMPC> 50% or nipple invasion,the application of radiotherapy in postoperative adjuvant therapy may bring more survival benefits.4.Although patients with breast IMPC have a high overall lymph node metastasis rate and poor prognosis,ER,PR positive,and endocrine therapy can still improve the their prognosis. |
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