The Imaging Research Of Invasive Micropapillary Carcinoma Of The Breast

Objective:To discuss the imaging features of the invasive micropapillary carcinoma of breast,the correlation between the imaging findings and lymph node metastasis.Methods:84 patients diagnosed with IMPC were included in the present study(include 19 cases of pure IMPC,60 cases of impure IMPC and 5 cases the ductal carcinoma in situ with IMPC).Mammographic,sonographic,and magnetic resonance imaging(MRI)findings were analyzed retrospectively with clinical and pathological data.And choose 60 NST cases of the same histological grade to analyzed as the control group of impure IMPC.The MRI manifestations of IMPC were divided into two groups according to the lymph node metastasis.Results:5 cases of ductal carcinoma in situ with IMPC breast X-ray mainly showed simple calcification;ultrasonography with irregular mass,the margin is not clear,normal or rear echo attenuation,internal mixed echo,often accompanied by duct expansion;MRI performance enhancement mainly to non mass like,the average value of ADC was(0.00101 + 0.000118)mm~2/s.8 cases of mammographic findings in 19 cases of pure IMPC presented as a irregular shape(85.7%),spiculated margin(71.4%)and high density(71.4%)mass,often accompanied by calcification(62.5%).15 cases of sonography displayed an irregular shape(100%),spiculated margin(60%)and hypoechoic mass,posterior acoustic features were normal(66.7%),the average resistive index of 11 cases was(0.81±0.08).The MRI findings of 19 cases were irregular shape(56.2%),spiculated margin(62.5%),inhomogeneous internal enhancement(87.5%)mass(84.2%),early rapid enhancement(63.2%),washout patterns(68.4%).the average ADC value of 8 cases in 11 cases(72.2%)was(0.000898±0.000322)mm~2/s.Both the 60 cases of the impure IMPC and the 60 cases of the same histological grade NST mammographic findings presented as a irregular shape,spiculated margin and high density mass,often accompanied by calcification.There was no statistical difference between them.The sonography of the two group both displayed irregular shapes,spiculated margins and hypoechoic masses,posterior acoustic features were normal,the average resistive index cases were(0.77±0.07)and(0.78±0.08).There was no statistical difference between them.The MRI findings were irregular shape,inhomogeneous internal enhancement mass,early rapid enhancement,washout patterns.Impure IMPC ofen accompanied by spiculated margin,compared with NST,there was a significant difference(P =0.049),the average ADC value of impure IMPC was(0.000873±0.000176)mm~2/s,less than NST(0.001058±0.000212)mm~2/s.there was statistical difference(P=0)MRI in the lymph node metastasis group and the non-lymph node metastasis group IMPC showed irregular shape ofen accompanied by spiculated margin,inhomogeneous internal enhancement mass,early rapid enhancement.The average ADC value of the lymph node metastasis group were(0.000853±0.000176)mm~2/s,less than the non-lymph node metastasis group(0.000963±0.000183)mm~2/s.There was statistical difference(P=0.017)Conclusion:IMPC are associated with higher invasive and lymph node metastases rates.The imaging findings of IMPC are highly suggestive of malignancy.The tumor showed irregular shape with spiculated margin,had calcifications in mammographic findings,had abundant blood flow in sonographic findings,ADC value in DWI-MRI is low.the average ADC value of the lymph node metastasis group were less than the non-lymph node metastasis group,it is suggested that IMPC with lower ADC value may be more likely to have lymph node metastasis than IMPC with higher ADC value.