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Long-term outcome of invasive pure micropapillary breast cancer compared with invasive mixed micropapillary and invasive ductal breast cancer: a matched retrospective study

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Abstract

Purpose

Data on the prognostic impact of the micropapillary component in breast cancer are limited. The purpose of this study was to investigate the clinicopathological characteristics and long-term outcomes of pure and mixed invasive micropapillary breast cancer (IMPC) patients compared to invasive ductal cancer (IDC) patients.

Methods

This retrospective study analysed all IMPC and IDC patients treated at the European Institute of Oncology (IEO) between 1997 and 2019. The overall cohort of IMPC patients was divided in two groups, pure and mixed IMPC. Each patient with mixed or pure IMPC was matched with one patient with IDC, based on year of surgery, age, pT, pN, and molecular subtype.

Results

A total of 30,115 IDC, 120 pure IMPC and 150 mixed IMPC patients were considered eligible. Compared to IDC, pure and mixed IMPC patients presented a higher rate of locally advanced disease (pT2-T3, pN2-N3), vascular invasion, and Luminal B subtype. After matching, pure and mixed IMPC showed a significant higher rate of vascular invasion compared to IDC patients (p < 0.001). Invasive disease-free survival was better in IDC compared to pure IMPC patients (p = 0.11). Long-term overall survival was significantly worse in pure IMPC group compared to IDC group (p = 0.004), being instead similar between mixed IMPC vs matched IDC (p = 0.07).

Conclusion

These real-world data reported the worse prognosis of pure IMPC compared to IDC, highlighting the peculiar prognostic value of the micropapillary subtype itself in the decision-making process of IMPC management. An accurate pre-surgical diagnostic evaluation and a multidisciplinary approach are pivotal to best personalize its treatment.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access database at the European Institute of Oncology.

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Acknowledgements

This work was partially supported by the Italian Ministry of Health with Ricerca Corrente 5 × 1000 funds.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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  1. Francesca Magnoni and Beatrice Bianchi contributed equally.

Authors and Affiliations

  1. Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy

    Francesca Magnoni, Beatrice Bianchi, Giovanni Corso, Roberta Brancaccio, Elisa Bottazzoli, Antony Boato, Galimberti Viviana & Paolo Veronesi

  2. Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy

    Eleonora Pagan, Isabella Sala & Vincenzo Bagnardi

  3. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

    Isabella Sala

  4. Department of Oncology and Hematology, University of Milano, Milan, Italy

    Giovanni Corso, Nicola Fusco & Paolo Veronesi

  5. Data Management, European Institute of Oncology, IRCCS, Milan, Italy

    Sangalli Claudia

  6. Division of Pathology, European Institute of Oncology, IRCCS, 20141, Milan, Italy

    Nicola Fusco

  7. Division of Medical Senology, European Institute of Oncology, IRCCS, Milan, Italy

    Elisabetta Munzone & Silvia Dellapasqua

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by FM, BB, EP, IS, VB and CS. The first draft of the manuscript was written by FM, BB, EP, IS and all authors contributed to manuscript review and editing. All authors read and approved the final version of the manuscript.

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Correspondence to Francesca Magnoni.

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Magnoni, F., Bianchi, B., Pagan, E. et al. Long-term outcome of invasive pure micropapillary breast cancer compared with invasive mixed micropapillary and invasive ductal breast cancer: a matched retrospective study. Breast Cancer Res Treat (2024). https://doi.org/10.1007/s10549-024-07422-7

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