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| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = good | | Prognosis = very good | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = other breast tumour | ||
| Tx = surgical | | Tx = surgical | ||
}} | }} | ||
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==General== | ==General== | ||
*Very good prognosis<ref name=pmid21753694>{{Cite journal | last1 = Rakha | first1 = EA. | last2 = Gandhi | first2 = N. | last3 = Climent | first3 = F. | last4 = van Deurzen | first4 = CH. | last5 = Haider | first5 = SA. | last6 = Dunk | first6 = L. | last7 = Lee | first7 = AH. | last8 = Macmillan | first8 = D. | last9 = Ellis | first9 = IO. | title = Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. | journal = Am J Surg Pathol | volume = 35 | issue = 8 | pages = 1093-103 | month = Aug | year = 2011 | doi = 10.1097/PAS.0b013e31821b3f65 | PMID = 21753694 }}</ref> - it is similar to [[DCIS]]. | *Very good prognosis<ref name=pmid21753694>{{Cite journal | last1 = Rakha | first1 = EA. | last2 = Gandhi | first2 = N. | last3 = Climent | first3 = F. | last4 = van Deurzen | first4 = CH. | last5 = Haider | first5 = SA. | last6 = Dunk | first6 = L. | last7 = Lee | first7 = AH. | last8 = Macmillan | first8 = D. | last9 = Ellis | first9 = IO. | title = Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. | journal = Am J Surg Pathol | volume = 35 | issue = 8 | pages = 1093-103 | month = Aug | year = 2011 | doi = 10.1097/PAS.0b013e31821b3f65 | PMID = 21753694 }}</ref> - it is similar to [[DCIS]]. | ||
* | *Classically menopausal women. | ||
*~30% present with bloody discharge.<ref name=pmid21057133>{{Cite journal | last1 = Rodríguez | first1 = MC. | last2 = Secades | first2 = AL. | last3 = Angulo | first3 = JM. | title = Best cases from the AFIP: intracystic papillary carcinoma of the breast. | journal = Radiographics | volume = 30 | issue = 7 | pages = 2021-7 | month = Nov | year = 2010 | doi = 10.1148/rg.307105003 | PMID = 21057133 | URL = http://radiographics.rsnajnls.org/cgi/pmidlookup?view=long&pmid=21057133 }}</ref> | *~30% present with bloody discharge.<ref name=pmid21057133>{{Cite journal | last1 = Rodríguez | first1 = MC. | last2 = Secades | first2 = AL. | last3 = Angulo | first3 = JM. | title = Best cases from the AFIP: intracystic papillary carcinoma of the breast. | journal = Radiographics | volume = 30 | issue = 7 | pages = 2021-7 | month = Nov | year = 2010 | doi = 10.1148/rg.307105003 | PMID = 21057133 | URL = http://radiographics.rsnajnls.org/cgi/pmidlookup?view=long&pmid=21057133 }}</ref> | ||
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***[[Nuclear atypia]] - including: nucleoli, [[nuclear pleomorphism]]. | ***[[Nuclear atypia]] - including: nucleoli, [[nuclear pleomorphism]]. | ||
Notes: | |||
< | *Many potential pitfalls with papillary breast lesions on needle core biopsy. | ||
**Complete excision is recommended<ref>{{Cite journal | last1 = Rizzo | first1 = M. | last2 = Linebarger | first2 = J. | last3 = Lowe | first3 = MC. | last4 = Pan | first4 = L. | last5 = Gabram | first5 = SG. | last6 = Vasquez | first6 = L. | last7 = Cohen | first7 = MA. | last8 = Mosunjac | first8 = M. | title = Management of papillary breast lesions diagnosed on core-needle biopsy: clinical pathologic and radiologic analysis of 276 cases with surgical follow-up. | journal = J Am Coll Surg | volume = 214 | issue = 3 | pages = 280-7 | month = Mar | year = 2012 | doi = 10.1016/j.jamcollsurg.2011.12.005 | PMID = 22244207 }}</ref>. | |||
*Adequately and carefully sample the specimen to exclude an invasive component. | |||
*Report only the size of the invasive component (if present) to prevent over-estimation of tumor stage. | |||
* | |||
* | |||
DDx<ref>{{Cite journal | last1 = Collins | first1 = LC. | last2 = Schnitt | first2 = SJ. | title = Papillary lesions of the breast: selected diagnostic and management issues. | journal = Histopathology | volume = 52 | issue = 1 | pages = 20-9 | month = Jan | year = 2008 | doi = 10.1111/j.1365-2559.2007.02898.x | PMID = 18171414 }} | DDx<ref>{{Cite journal | last1 = Collins | first1 = LC. | last2 = Schnitt | first2 = SJ. | title = Papillary lesions of the breast: selected diagnostic and management issues. | journal = Histopathology | volume = 52 | issue = 1 | pages = 20-9 | month = Jan | year = 2008 | doi = 10.1111/j.1365-2559.2007.02898.x | PMID = 18171414 }} | ||
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**The solid variant looks basaloid - solid adenoid cystic carcinoma or a 'basal-like' carcinoma should be considered in these cases. | **The solid variant looks basaloid - solid adenoid cystic carcinoma or a 'basal-like' carcinoma should be considered in these cases. | ||
===Images=== | |||
<gallery> | |||
Image:Breast PapillaryCarcinomaEncysted 3 PA.JPG|Breast - Intracystic Papillary Carcinoma - Medium power (SKB) | |||
Image:Breast PapillaryCarcinomaEncysted 2 PA.JPG|Breast - Intracystic Papillary Carcinoma - Medium power (SKB) | |||
Image:Breast PapillaryCarcinomaEncysted PA.JPG|Breast - Intracystic Papillary Carcinoma - High power (SKB) | |||
Image:Breast Carcinoma Papillary Intracystic SolidVariant LP CTR.jpg|Breast - Papillary Intracystic Carcinoma, Solid Variant - low power (SKB) | |||
Image:Breast Carcinoma Papillary Intracystic SolidVariant MP2 CTR.jpg|Breast - Papillary Intracystic Carcinoma, Solid Variant - medium power (SKB) | |||
Image:Breast Carcinoma Papillary Intracystic SolidVariant MP CTR.jpg|Breast - Papillary Intracystic Carcinoma, Solid Variant - medium power (SKB) | |||
Image:Breast Carcinoma Papillary Intracystic SolidVariant HP2 CTR.jpg|Breast - Papillary Intracystic Carcinoma, Solid Variant - high power (SKB) | |||
Image:Breast Carcinoma Papillary Intracystic SolidVariant HP CTR.jpg|Breast - Papillary Intracystic Carcinoma, Solid Variant - high power (SKB) | |||
Image:Breast EncystedPapillaryCarcinoma InfiltratingDuctalCarcinoma PA.JPG|Breast - Intracystic papillary adenocarcinoma (top) with associated invasive ductal carcinoma (bottom) (SKB) | |||
</gallery> | |||
*WebPathology<http://www.webpathology.com/images/noimage.gif> | |||
*WebPathology<http://www.webpathology.com/images/noimage.gif> | |||
*WebPathology<http://www.webpathology.com/images/noimage.gif> | |||
==IHC== | ==IHC== |
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