Invasive Micropapillary Carcinoma with CEP17 Monosomy of the Bilateral Breast: A Rare Case Report and Review of the Literature

• Main Authors: Zhang L, Wang Y, Xing H, Niu C, Yu Q, Tang L
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-07-01
• Series: OncoTargets and Therapy
• Subjects: human epidermal growth factor receptor 2; breast cancer; fluorescence in situ hybridization; chromosome enumeration probe 17 (cep17)
• Online Access: https://www.dovepress.com/invasive-micropapillary-carcinoma-with-cep17-monosomy-of-the-bilateral-peer-reviewed-article-OTT

Le Zhang,1,* Yuechen Wang,2,* Leichao Zhang,3 Hua Xing,1 Chunbo Niu,3 Qiong Yu,4 Lu Tang1 1Department of Breast Surgery, The Third Hospital of Jilin University, Changchun, Jilin 130033, People’s Republic of China; 2Department of Breast Surgery, Tohoku University Hospital, Sendai, Miyagi 980-0000, Japan; 3Department of Pathology, The Third Hospital of Jilin University, Changchun, Jilin 130033, People’s Republic of China; 4Department of Radiology, The Third Hospital of Jilin University, Changchun, Jilin 130033, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lu Tang Phone/ Fax [phone]Email [e-mail]: Invasive micropapillary carcinoma (IMPC) is a novel type of breast cancer which is potentially very aggressive and may show early lymphatic infiltration. Monosomy of chromosome 17 (m17) is rare in breast cancer, and according to the 2018 guidelines of the American Society of Clinical Oncology/College of American Pathologists, the decision to administer trastuzumab treatment should be made based on positive human epidermal growth factor receptor 2 results by immunohistochemistry. Here, we report a rare case of bilateral local advanced IMPC involving m17. A 33-year-old woman found a mass measuring 30 mm on the left breast that increased to 100 mm over 3 months. A diagnosis of IMPC was made based on the findings of core needle biopsies of bilateral breast masses and left axillary lymph node, and m17 was detected by fluorescence in situ hybridization (FISH). The patient underwent 6 cycles of neoadjuvant chemotherapy (docetaxel, epirubicin, and cyclophosphamide) and left-side modified radical mastectomy, left axillary lymph node dissection, right breast-conserving surgery, and right sentinel lymph node biopsy. Postoperative pathologic analysis of both breasts revealed IMPC, and m17 was confirmed by FISH. The patient received radiotherapy and endocrine therapy but rejected trastuzumab treatment. The patient was still alive at the 30-month follow-up, without recurrence or metastasis. Our findings suggest that loss of chromosome 17 may influence prognosis or therapeutic response, which needs to be further confirmed.Keywords: human epidermal growth factor receptor 2, breast cancer, fluorescence in situ hybridization, chromosome enumeration probe 17, CEP17