The Research Of The Clinical And Pathological Characteristics Of The Invasive Micropapillary Carcinoma Of Breast Cancer

Background:Breast cancer is the leading cause of fatal tumor diseases for women around the world.Although the incidence of breast cancer in China is relatively lower than it in the world,it has a very fast growth and has become the first female tumor of China now.The high incidence and mortality of breast cancer have led to the continuous efforts of breast oncologists and related scholars to seek more accurate and individualized treatment methods.There are many classification method of breast cancer,and it usually be divided into three types including non-invasive carcinoma,special invasive carcinoma and general invasive carcinoma,different type has different prognosis.Invasive micropapillary carcinoma is an independent subtype of invasive breast cancer in epithelial tumors.Its incidence is low.Compared with general invasive cancer,IMPC has a high rate of lymph node metastasis and lymphatic permeation,and a high degree of malignancy and poor prognosis.However,the mechanism of lymph node metastasis and the cause of poor prognosis of IMPC have not been studied explicitly.With the advancement of science and tumor research,the diagnosis and treatment of tumor has been based on the level of molecular biology.Even the histologically identical tumors have different treatment principles and prognosis.Molecular biological indicators such as ER,PR,HER-2,and Ki-67,which are closely related to the prognosis of breast cancer and can guide the selection of adjuvant therapeutic measures,have been received attention from clinical staff and scholars.At the same time,for breast cancer patients,the clinical characteristics such as the age of onset and the size of the tumor are also important factors in assessing their prognosis.Objective:To compare the clinical and pathological characteristics and the expression of molecular biological markers between invasive micropapillary carcinoma and invasive ductal carcinoma,and explore the cause of poor prognosis of invasive micropapillary carcinoma.Methods:The data of 43 patients with IMPC admitted to the Department of Breast Surgery at the Second Hospital of Jilin University from January 2010 to December 2016 were taken as the experimental group,and the data of 90 patients with IDC treated at the same time were randomly selected as the control group.Compared the differences of clinical and pathological data between the two groups,including the age of onset,the size of the primary tumor,the rate and number of lymph node metastases,the incidence of vascular invasion,the expression of ER,PR,HER-2,and Ki-67.Within the IMPC group,we record the components of IMPC.Results:1.In the IMPC group,the age of onset was from 34 to 70 years old,and the average age of onset was 54.79 years old.The age of onset in the IDC group was from 30 to 82 years old and the average age of onset was 51.46 years old.The average age of onset was higher in the IMPC group than in the IDC group,but there was no significant difference between the two groups(P=0.055).Of the 43 patients with IMPC,1 was at the age of onset?35 years old,42 were at the age of onset ?35 years old,in the 90 patients with IDC,5 was at the age of onset ? 35 years old,85 were at the age of onset >35 years old.There was no significant difference between the two groups(P=0.401).2.In the IMPC group,the tumor diameter ranged from 0.15 to 8.90 cm and the median diameter was 2.00 cm.In the IDC group,the tumor diameter ranged from 0.60 to 6.20 cm with a median diameter of 1.90 cm.In 43 patients with IMPC,the primary tumor size in T1 were 24 cases,T2 were 14 cases,and T3 were 5 cases.In 90 cases of IDC,the primary tumor size in T1 were 55 cases,T2 were 33 cases and T3 were 2 cases.The difference between the two group was not statistically significant(P=0.075).3.In the IMPC group,the lymph node metastasis rate was 69.77%,and the average number of metastases was 7.74.In the IDC group,the lymph node metastasis rate was 50.00%,and the average number of metastases was 4.60,the lymph node metastasis rate in the IMPC group was significantly higher than that in the IDC group,and the difference between the two groups was statistically significant(P=0.032).Among the 43 patients with IMPC,the number of lymph node metastases in N0 were 13 cases,in N1 were 13 cases,in N2 were 3cases,and in N3 were 14 cases.Among the 90 patients with IDC,the number of lymph node metastases in N0 were 45 cases,in N1 were 27 cases,in N2 were 11 cases,and in N3 were 7 cases.There was a statistically significant difference between the two groups(P<0.001).The incidence of vascular invasion in the IMPC group was 62.79%,and the vascular invasion rate in the IDC group was 28.89%.The vascular invasion rate in the IMPC group was significantly higher than it in the IDC group,and there was a statistically significant difference between the two groups(P<0.001).4.The positive expression rate of ER was 97.67% in the IMPC group and 81.11% in the IDC group,the IMPC group was significantly higher than the IDC group(P=0.009);The positive expression rate of PR was 93.02% and 81.11% in the IMPC group and the IDC group,there was no statistically significant difference between the IMPC group and the IDC group(P=0.072).HER-2 positive expression rate in the IMPC group and the IDC group were 13.95% and 23.33% respectively,there was no significant statistical difference between IMPC group and IDC group(P= 0.208);Ki-67 high expression rate in the IMPC group and IDC group were 76.74% and 96.67% respectively,the IMPC group was significantly lower than the IDC group(P <0.001).Conclusion:1.There was no significant difference in the age of onset between the IMPC group and the IDC group,and the age of onset was not an independent risk factor for poor prognosis of IMPC compared with IDC.2.The incidence of vascular invasion,lymph node metastasis,and the number of lymph node metastasis in the IMPC group were higher than that those in the IDC group.Compared with IDC,IMPC has a stronger ability to invade invasiveness,and this ability is not related to the proportion of IMPC in lesions.3.There was no significant difference in the size of the primary tumor between IMPC and IDC.Tumor diameter was not an independent risk factor for the poor prognosis of IMPC.4.The positive expression rate of ER and the low expression rate of Ki-67 in IMPC were significantly higher than those in IDC.The expression rate of PR and HER-2 were not statistically different between the two groups,and could not be used as independent risk factors for predicting the prognosis of IMPC.