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Invasive Micropapillary Carcinoma of the Breast: MR Imaging Findings

  • Lim, Hyo Soon (Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital) ;
  • Kuzmiak, Cherie M. (Department of Radiology, University of North Carolina at Chapel Hill) ;
  • Jeong, Seo In (Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital) ;
  • Choi, You Ri (Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital) ;
  • Kim, Jin Woong (Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital) ;
  • Lee, Ji Shin (Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital) ;
  • Park, Min Ho (Department of Surgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital)
  • Received : 2012.05.14
  • Accepted : 2013.03.08
  • Published : 2013.07.01

Abstract

Objective: To analyze the magnetic resonance (MR) imaging findings of invasive micropapillary carcinoma of the breast. Materials and Methods: MR images were retrospectively evaluated in 14 patients (age range: 37-67, mean age: 49 years) with pathologically confirmed invasive micropapillary carcinoma of the breast. The enhancement type (mass/non-mass), shape, margin, contrast enhancement, and time-intensity curve pattern on the dynamic study were correlated with the histopathologic features. Associated findings, such as edema, nipple change, skin change and enlarged axillary lymph nodes were also studied. Results: The most common features of the masses were irregular shape (12 of 14 patients, 85.8%) and irregular or spiculated margin (11 of 14 patients, 78.7%). The contrast enhancement was heterogeneous in 11 patients (78.7%), rim enhancement in 2 cases (14.2%), and homogeneous in one patient (7.1%). The predominant kinetic pattern was rapid increase (14 of 14, 100%) in the initial phase and washout (11 of 14, 78.7%) in the delayed phase. Associated non-mass like enhancement was shown in 4 patients, representing ductal carcinoma in situ. MR imaging helped detect additional sites of cancer other than the index lesion in 3 patients (21.4%). Enlarged axillary lymphadenopathy was identified in 7 of the 14 patients (50%). Conclusion: Invasive micropapillary carcinoma appears as a mass with an irregular shape, irregular or spiculated margin and heterogeneous enhancement on MR imaging. Though these findings are not specific and are also observed with other breast malignancies, invasive micropapillary carcinoma frequently showed multiple lesions, accompanying non-mass enhancement and axillary lymph node enlargement.

Keywords

References

  1. Luna-More S, Gonzalez B, Acedo C, Rodrigo I, Luna C. Invasive micropapillary carcinoma of the breast. A new special type of invasive mammary carcinoma. Pathol Res Pract 1994;190:668-674 https://doi.org/10.1016/S0344-0338(11)80745-4
  2. Paterakos M, Watkin WG, Edgerton SM, Moore DH 2nd, Thor AD. Invasive micropapillary carcinoma of the breast: a prognostic study. Hum Pathol 1999;30:1459-1463 https://doi.org/10.1016/S0046-8177(99)90168-5
  3. Kuroda H, Sakamoto G, Ohnisi K, Itoyama S. Clinical and pathologic features of invasive micropapillary carcinoma. Breast Cancer 2004;11:169-174 https://doi.org/10.1007/BF02968297
  4. Pettinato G, Manivel CJ, Panico L, Sparano L, Petrella G. Invasive micropapillary carcinoma of the breast: clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior. Am J Clin Pathol 2004;121:857-866 https://doi.org/10.1309/XTJ7VHB49UD78X60
  5. Yu JI, Choi DH, Park W, Huh SJ, Cho EY, Lim YH, et al. Differences in prognostic factors and patterns of failure between invasive micropapillary carcinoma and invasive ductal carcinoma of the breast: matched case-control study. Breast 2010;19:231-237 https://doi.org/10.1016/j.breast.2010.01.020
  6. American College of Radiology. Mammography. In: Breast imaging reporting and data system (BI-RADS), 4th ed. Reston, VA: American College of Radiology, 2003
  7. American College of Radiology. Ultrasound. In: Breast imaging reporting and data system (BI-RADS), 4th ed. Reston, VA: American College of Radiology, 2003
  8. American College of Radiology. MRI. In: Breast imaging reporting and data system (BI-RADS), 4th ed. Reston, VA: American College of Radiology, 2003
  9. Liberman L, Morris EA, Dershaw DD, Abramson AF, Tan LK. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol 2003;180:901-910 https://doi.org/10.2214/ajr.180.4.1800901
  10. Siriaunkgul S, Tavassoli FA. Invasive micropapillary carcinoma of the breast. Mod Pathol 1993;6:660-662
  11. Gunhan-Bilgen I, Zekioglu O, Ustun EE, Memis A, Erhan Y. Invasive micropapillary carcinoma of the breast: clinical, mammographic, and sonographic findings with histopathologic correlation. AJR Am J Roentgenol 2002;179:927-931 https://doi.org/10.2214/ajr.179.4.1790927
  12. Adrada B, Arribas E, Gilcrease M, Yang WT. Invasive micropapillary carcinoma of the breast: mammographic, sonographic, and MRI features. AJR Am J Roentgenol 2009;193:W58-W63 https://doi.org/10.2214/AJR.08.1537
  13. Kubota K, Ogawa Y, Nishioka A, Murata Y, Itoh S, Hamada N, et al. Radiological imaging features of invasive micropapillary carcinoma of the breast and axillary lymph nodes. Oncol Rep 2008;20:1143-1147
  14. Ota D, Toyama T, Ichihara S, Mizutani M, Kamei K, Iwata H. A case of invasive micropapillary carcinoma of the breast. Breast Cancer 2007;14:323-326 https://doi.org/10.2325/jbcs.14.323
  15. Walsh MM, Bleiweiss IJ. Invasive micropapillary carcinoma of the breast: eighty cases of an underrecognized entity. Hum Pathol 2001;32:583-589 https://doi.org/10.1053/hupa.2001.24988
  16. Luna-More S, Casquero S, Perez-Mellado A, Rius F, Weill B, Gornemann I. Importance of estrogen receptors for the behavior of invasive micropapillary carcinoma of the breast. Review of 68 cases with follow-up of 54. Pathol Res Pract 2000;196:35-39 https://doi.org/10.1016/S0344-0338(00)80019-9
  17. Nassar H, Wallis T, Andea A, Dey J, Adsay V, Visscher D. Clinicopathologic analysis of invasive micropapillary differentiation in breast carcinoma. Mod Pathol 2001;14:836- 841 https://doi.org/10.1038/modpathol.3880399
  18. Guo X, Chen L, Lang R, Fan Y, Zhang X, Fu L. Invasive micropapillary carcinoma of the breast: association of pathologic features with lymph node metastasis. Am J Clin Pathol 2006;126:740-746 https://doi.org/10.1309/AXYY4AJTMNW6FRMW

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