Abstract
Invasive micropapillary carcinoma is a special subtype of invasive breast cancer with characteristic morula and pseudo papillae of eosinophilic tumor cells surrounded by clear space. Association with lymphovascular invasion and early nodal metastasis makes it an aggressive tumor. We present a case of a 51 years old female with awareness of lump in left breast. On USG a presumptive diagnosis of breast carcinoma was suggested post which she underwent modified radical mastectomy. On histopathology, diagnosis of Invasive micropapillary carcinoma, breast with metastatic deposits in 23/26 lymph nodes was given. It is a rare and aggressive form of tumor with high rate of recurrence. Timely and accurate diagnosis is required for improving outcome of the patient.
References
- Sinn HP, Kreipe H. A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition. Breast Care (Basel). 2013;8(2):149-154.
- Hoda SA, Brogi E, Koerner FC, Rosen PP. Rosen's Breast Pathology. 4th ed. New York, NY: Lippincott, Williams, and Wilkins;2014:763-772.
- Nassar H, Wallis T, Andea A, Dey J, Adsay V, Visscher D: Clinicopathologic analysis of invasive micropapillary differentiation in breastcarcinoma. Mod Pathol 2001, 14:836–841.
- Petersen JL. Breast carcinomas with an unexpected inside out growth pattern. Rotation of polarization associated with angioinvasion. Pathol Res Pract 1993;189:780.
- Siriaunkgul S, Tavassoli FA. Invasive micropapillary carcinoma of the breast. Mod Pathol 1993;6:660–2
- Tavassoli FA, Devilee P. Pathology and Genetics of Tumours of the Breast and Female Genital Organs. Lyon, France: IARC Press; World Health Organization Classification of Tumours. 2003:35–6.
- Gokce H, Durak MG, Akin MM, Canda T, Balci P, Ellidokuz H, Demirkan B, Gorken IB, Sevinc AI, Kocdor MA, Saydam S, Harmancioglu O. Invasive micropapillary carcinoma of the breast: a clinicopathologic study of 103 cases of an unusual and highly aggressive variant of breast carcinoma. Breast J. 2013 Jul-Aug;19(4):374-81.
- Cserni, G. 2020. Histological type and typing of breast carcinomas and the WHO classification changes over time. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology. 112, 1 (Mar. 2020), 25-41.
- Fernandes D, Sousa MO, Pires-Luís AS, Dias CG, Leal C, Abreu de Sousa J. Pure invasive micropapillary carcinoma of the breast: A 10-year case review of a rare and aggressive subtype of breast carcinoma. Edorium J Surg 2017;4:41–49.
- Wu, Y., Zhang, N. & Yang, Q. The prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in the breast: a meta-analysis. BMC Cancer.2017;17:
- Gong Y, Sun X, Huo L, Wiley EL, Rao MS. Expression of cell adhesion molecules, CD44s and e-cadherin, and micro vessel density in invasive micropapillary carcinoma of the breast. Histopathol 2005; 46:24-30
- Walsh MM, Bleiweiss IJ. Invasive micropapillary carcinoma of the breast: eighty cases of an under recognized entity. Hum Pathol 2001; 32:583-9
- Amin MB, Ro JY, el-Sharkawy T, et al. Micropapillary variant of transitional cell carcinoma of the urinary bladder. Histologic pattern resembling ovarian papillary serous carcinoma. Am J Surg Pathol 1994;18:1224-32.
Corresponding Author
Dr Anchana Gulati
Associate Professor, Department of Pathology, IGMC Shimla, India
DOI: https://dx.doi.org/10.18535/jmscr/v9i3.29
