Invasive micropapillary carcinoma (IMPC) is a rare, distinct histological subtype of breast carcinoma. While micropapillary histological architecture is found in up to 2-8% of all breast cancers, pure micropapillary carcinoma is infrequent and comprises 0.9-2% of breast carcinomas. Invasive micropapillary carcinoma is emerging as an oncological and surgical challenge due to a plethora of characteristics that constitute this histological pattern - interestingly, both elusive and aggressive. We present the case of a woman presenting with IMPC, who was primarily treated with tumour and lymph node marking, followed by primary systemic therapy (PST), and consequent oncoplastic surgery with sentinel lymph node biopsy. Our case report outlines the importance of awareness of histological subtypes in breast cancer by focusing on a case report of IMPC. The breast surgeon must be aware of the lymphotropic behaviour of this subtype and the high prevalence of lymph node involvement in such patients, and therefore focus on rigorous axillary assessment. One must not forget that, despite having a more aggressive biological profile, IMPC has demonstrated no difference in survival when compared to other histological subtypes, and treatment should conform to international guidelines with an emphasis on nodal staging.
Keywords: breast; carcinoma; invasive; micropapillary.
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