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The reversed apical pattern of MUC1 expression is characteristics of invasive micropapillary carcinoma of the breast

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Abstract

Background

Invasive micropapillary carcinoma (IMPC) of the breast is a special subtype of invasive ductal carcinoma (IDC), which is known to have a high potential to metastasize to the axillary lymph node. However, it is sometimes difficult to differentiate IMPC from conventional IDC showing an IMPC-like pattern due to artifact (pseudo-IMPC). In the present study, we investigated the usefulness of immunohistochemical expression of MUC1 for distinguishing IMPC from pseudo-IMPC, and analyzed several clinicopathological parameters of IMPC and pseudo-IMPC cases.

Methods

Eighty cases showing IMPC or IMPC-like pattern were selected from our surgical files of 1240 cases of IDC. We examined the expression of MUC1, D2-40 and CD34 by immunohistochemistry.

Results

Eighty cases were classified into 9 cases (0.7%) of pure-IMPC, 31 cases (2.5%) of mixed-IMPC, and 40 cases of pseudo-IMPC, according to the expression pattern of MUC1. In pure-IMPC cases, MUC1 expression was found at the reversed apical membrane of neoplastic cell clusters, while in pseudo-IMPC, MUC1 expression was present in the whole cytoplasmic membrane and/or cytoplasm. There were no significant differences among the three groups in patient age, tumor size and nuclear grade of neoplastic cells. However, lymphatic invasion and lymph node metastasis in the pure-IMPC or mixed-IMPC cases were higher than those in pseudo-IMPC cases with statistically significant values. Pure-IMPC has a higher recurrence rate and lower overall survival compared to pseudo-IMPC [P=0.0165(DFS)P=0.025(OS) ].

Conclusions

This study demonstrated that immunohistochemistry of MUC1 is useful for the diagnosis of IMPC. The pure-IMPC cases had higher incidences of lymphatic invasion and lymph node metastasis, and also showed a poorer prognosis.

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Authors and Affiliations

  1. Department of Pathology, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, 734-8551, Hiroshima, Japan

    Yu-sang Li, Mayumi Kaneko, Danielle Giacometti Sakamoto, Yukio Takeshima & Kouki Inai

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  1. Yu-sang Li
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  2. Mayumi Kaneko
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  3. Danielle Giacometti Sakamoto
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  4. Yukio Takeshima
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  5. Kouki Inai
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Correspondence to Kouki Inai.

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Li, Ys., Kaneko, M., Sakamoto, D.G. et al. The reversed apical pattern of MUC1 expression is characteristics of invasive micropapillary carcinoma of the breast. Breast Cancer 13, 58–63 (2006). https://doi.org/10.2325/jbcs.13.58

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  • DOI: https://doi.org/10.2325/jbcs.13.58

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