AIM: To analyse the various imaging features of invasive micropapillary carcinoma (IMPC), a
distinct variant of breast cancer, by mammography, ultrasound, and contrast-enhanced
mammography.
MATERIALS AND METHODS: This study included 68 female patients with histopathologically
proven invasive micropapillary carcinoma who underwent mammography, ultrasound, and
contrast-enhanced mammography examinations. The findings encountered by each imaging
tool were analysed using the Breast Imaging Reporting and Data System (BI-RADS) lexicon.
RESULTS: In this retrospective study, 64.7% of cases were of the pure form of IMPC. Most of
the cases showed an aggressive clinical course, with lymphovascular invasion noted in 76.5% of
cases, while 60.3% of cases showed associated pathological lymphadenopathy. The N3 stage
was reported in 25% of cases. On analysing the mammographic and ultrasound imaging
findings, a significant association between irregular shape and a non-circumscribed margin
with IMPC was found. Associated calcification was noted in 47% of cases. Pathological
enhancement of moderate or marked conspicuity was noted in cases that underwent contrastenhanced
mammography, with the most commonly encountered finding being enhancing
irregular and non-circumscribed masses.
CONCLUSION: The mammographic and ultrasound imaging features of IMPC are indistinguishable
from other aggressive types of breast cancer. At contrast-enhanced mammography
examination, pathological enhancement of moderate to marked conspicuity was shown in all
cases. The observed strong association of IMPC with lymphovascular invasion and lymph node
metastasis with higher nodal stage in this study mandate meticulous sonographic examination
of the axilla, as well as the infra, and supraclavicular regions if pathological axillary lymphadenopathy
was noted. |
