Skip to main content

Advertisement

SpringerLink
Log in

Papillary carcinoma of the breast: an overview

  • Review
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Papillary carcinoma of the breast represents ~0.5% of all newly diagnosed cases of breast cancer. The prevalence of both invasive and in situ papillary carcinoma seems to be greater in older postmenopausal women and, in relative terms, in males. Histologic features of the tumor include cellular proliferations surrounding fibrovascular cores, with or without invasion. In this review, characteristics of both in situ and invasive disease are outlined. Immunohistochemical analyses of papillary carcinoma suggest the utility of markers such as smooth muscle myosin heavy chain, calponin, p63, and high molecular weight keratins, which can characterize the myoepithelial cell layer. With respect to radiographic evaluation of papillary carcinoma, ultrasonography is the most extensively studied imaging modality, though magnetic resonance mammography has potential utility. Available data suggest improved outcome for papillary carcinoma as compared to invasive ductal carcinoma. Treatment-related information for patients with papillary carcinoma is limited, and patterns noted in available series suggest a variable approach to this disease. The scarcity of information underscores the need for further treatment- and outcome-related studies in papillary carcinoma of the breast.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics, 2009. CA A Cancer J Clin 59(4):225–249

    Article  Google Scholar 

  2. Louwman MWJ, Vriezen M, van Beek MW, Nolthenius-Puylaert MC, van der Sangen MJ, Roumen RM et al (2007) Uncommon breast tumors in perspective: incidence, treatment and survival in the Netherlands. Int J Cancer 121(1):127–135

    Article  CAS  PubMed  Google Scholar 

  3. McCulloch GL, Evans AJ, Yeoman L (1997) Radiological features of papillary carcinoma of the breast. Clin Radiol 73:865–868

    Article  Google Scholar 

  4. Grabowski J, Salzstein SL, Sadler GR, Blair S (2008) Intracystic papillary carcinoma. Cancer 113(5):916–920

    Article  PubMed  Google Scholar 

  5. Mulligan AM, O’Malley FP (2007) Papillary lesions of the breast: a review. Adv Anat Pathol 14(2):108–119

    Article  PubMed  Google Scholar 

  6. Collins LC, Schnitt SJ (2008) Papillary lesions of the breast: selected diagnostic and management issues. Histopathology 52(1):20–29

    CAS  PubMed  Google Scholar 

  7. Ueng SH, Mezzetti T, Tavassoli FA (2009) Papillary neoplasms of the breast: a review. Arch Pathol Lab Med 133(6):893–907

    PubMed  Google Scholar 

  8. Page DL, Salhany KE, Jensen RA, Dupont WD (1996) Subsequent breast carcinoma risk after biopsy with atypia in a breast papilloma. Cancer 78(2):258–266

    Article  CAS  PubMed  Google Scholar 

  9. Hill CB, Yeh IT (2005) Myoepithelial cell staining patterns of papillary breast lesions. Am J Clin Pathol 123(1):36–44

    Article  PubMed  Google Scholar 

  10. Collins LC, Carlo VP, Hwang H, Barry TS, Gown AM, Schnitt SJ (2006) Intracystic papillary carcinomas of the breast: a reevaluation using a panel of myoepithelial cell markers. Am J Surg Pathol 30(8):1002–1007

    Article  PubMed  Google Scholar 

  11. Esposito NN, Dabbs DJ, Bhargava R (2009) Are encapsulated papillary carcinomas of the breast in situ or invasive? A basement membrane study of 27 cases. Am J Clin Pathol 131(2):228–242

    Article  PubMed  Google Scholar 

  12. Maluf HM, Koerner FC (1995) Solid papillary carcinoma of the breast. A form of intraductal carcinoma with endocrine differentiation frequently associated with mucinous carcinoma. Am J Surg Pathol 19(11):1237–1244

    Article  CAS  PubMed  Google Scholar 

  13. Nassar H, Qureshi H, Volkanadsay N, Visscher D (2006) Clinicopathologic analysis of solid papillary carcinoma of the breast and associated invasive carcinomas. Am J Surg Pathol 30(4):501–507

    Article  PubMed  Google Scholar 

  14. Moritani S, Ichihara S, Kushima R, Okabe H, Bamba M, Kobayashi T et al (2007) Myoepithelial cells in solid variant of intraductal papillary carcinoma of the breast: a potential diagnostic pitfall and a proposal of an immunohistochemical panel in the differential diagnosis with intraductal papilloma with usual ductal hyperplasia. Virchows Arch 450(5):539–547

    Article  PubMed  Google Scholar 

  15. Nicolas MM, Wu Y, Middleton LP, Gilcrease MZ (2007) Loss of myoepithelium is variable in solid papillary carcinoma of the breast. Histopathology 51(5):657–665

    Article  CAS  PubMed  Google Scholar 

  16. Fisher ER, Palekar AS, Redmond C (1980) Pathologic findings from the National Surgical Adjuvant Breast Project (protocol no. 4) VI. Invasive papillary cancer. Am J Clin Pathol 73:313–322

    CAS  PubMed  Google Scholar 

  17. Walsh MM, Bleiweiss IJ (2001) Invasive micropapillary carcinoma of the breast: eighty cases of an underrecognized entity. Hum Pathol 32(6):583–589

    Article  CAS  PubMed  Google Scholar 

  18. Nassar H, Wallis T, Andea A, Dey J, Adsay V, Visscher D (2001) Clinicopathologic analysis of invasive micropapillary differentiation in breast carcinoma. Mod Pathol 14(9):836–841

    Article  CAS  PubMed  Google Scholar 

  19. Pettinato G, Manivel CJ, Panico L, Sparano L, Petrella G (2004) Invasive micropapillary carcinoma of the breast. Am J Clin Pathol 121(6):857–866

    Article  PubMed  Google Scholar 

  20. Shah VI, Flowers CI, Douglas-Jones AG, Dallimore NS, Rashid M (2006) Immunohistochemistry increases the accuracy of diagnosis of benign papillary lesions in breast core needle biopsy specimens. Histopathology 48(6):683–691

    Article  CAS  PubMed  Google Scholar 

  21. Grin A, O’Malley FP, Mulligan AM (2009) Cytokeratin 5 and estrogen receptor immunohistochemistry as a useful adjunct in identifying atypical papillary lesions on breast needle core biopsy. Am J Surg Pathol 33(11):1615–1623

    Article  PubMed  Google Scholar 

  22. Rabban JT, Koerner FC, Lerwill MF (2006) Solid papillary ductal carcinoma in situ versus usual ductal hyperplasia in the breast: a potentially difficult distinction resolved by cytokeratin 5/6. Hum Pathol 37(7):787–793

    Article  CAS  PubMed  Google Scholar 

  23. Tan PH, Aw MY, Yip G, Bay BH, Sii LH, Murugaya S et al (2005) Cytokeratins in papillary lesions of the breast: is there a role in distinguishing intraductal papilloma from papillary ductal carcinoma in situ? Am J Surg Pathol 29(5):625–632

    Article  PubMed  Google Scholar 

  24. Cristofano CD, Mrad K, Zavaglia K, Bertacca G, Aretini P, Cipollini G et al (2005) Papillary lesions of the breast: a molecular progression? Breast Cancer Res Treat 90(1):71–76

    Article  PubMed  Google Scholar 

  25. Tsuda H, Takarabe T, Inazawa J, Hirohashi S (1997) Detection of numerical alterations of chromosomes 3, 7, 17 and X in low-grade intracystic papillary tumors of the breast by multi-color fluorescence in situ hybridization. Breast Cancer 4(4):247–252

    Article  PubMed  Google Scholar 

  26. Ganesan S, Karthik G, Joshi M, Damodaran V (2006) Ultrasound spectrum in intraductal papillary neoplasms of breast. Br J Radiol 79(946):843–849

    Article  CAS  PubMed  Google Scholar 

  27. Kim TH, Kang DK, Kim SY, Lee EJ, Jung YS, Yim H (2008) Sonographic differentiation of benign and malignant papillary lesions of the breast. J Ultrasound Med 27(1):75–82

    PubMed  Google Scholar 

  28. Lam WWM, Chu WCW, Tang APY, Tse G, Ma TKF (2006) Role of radiologic features in the management of papillary lesions of the breast. Am J Roentgenol 186(5):1322–1327

    Article  CAS  Google Scholar 

  29. Linda A, Londero V, Mazzarella F, Zuiani C, Bazzocchi M (2007) Rare breast neoplasms: is there any peculiar feature on magnetic resonance mammography? Radiol Med 112(6):850–862

    Article  CAS  PubMed  Google Scholar 

  30. Bernik SF, Troob S, Ying BL, Simpson SA, Axelrod DM, Siegel B et al (2009) Papillary lesions of the breast diagnosed by core needle biopsy: 71 cases with surgical follow-up. Am J Surg 197(4):473–478

    Article  PubMed  Google Scholar 

  31. Anderson W, Devesa SS (2005) In situ male breast carcinoma in the surveillance, epidemiology, and end results database of the National Cancer Institute. Cancer 104(8):1733–1741

    Article  PubMed  Google Scholar 

  32. Burga A, Fadare O, Lininger R, Tavassoli F (2006) Invasive carcinomas of the male breast: a morphologic study of the distribution of histologic subtypes and metastatic patterns in 778 cases. Virchows Arch 449(5):507–512

    Article  PubMed  Google Scholar 

  33. Anan H, Okazaki M, Fujimitsu R, Hamada Y, Sakata N, Nanbu M (2000) Intracystic papillary carcinoma in the male breast. A case report. Acta Radiol 41(3):227–229

    Article  CAS  PubMed  Google Scholar 

  34. Bhatia A, Saikia UN, Kumar Y (2008) Rare coexistence of invasive papillary carcinoma with infiltrating ductal carcinoma in male breast: report of a case. Int J Surg Pathol 16(3):311–313

    Article  PubMed  Google Scholar 

  35. Blaumeiser B, Tjalma W, Verslegers I et al (2002) Invasive papillary carcinoma of the male breast. Eur Radiol 12(9):2207–2210

    CAS  PubMed  Google Scholar 

  36. Dragoumis D, Tsiftsoglou A (2008) Intracystic papillary carcinoma associated with ductal carcinoma in situ in a male breast. J Postgrad Med 54(1):39–40

    Article  CAS  PubMed  Google Scholar 

  37. Imoto S, Hasebe T (1998) Intracystic papillary carcinoma of the breast in male: case report and review of the Japanese literature. Jpn J Clin Oncol 28(8):517–520

    Article  CAS  PubMed  Google Scholar 

  38. Pacelli A, Bock BJ, Jensen EA, Heerden JA, Reynolds C (2002) Intracystic papillary carcinoma of the breast in a male patient diagnosed by ultrasound-guided core biopsy: a case report. Breast J 8(6):387–390

    Article  PubMed  Google Scholar 

  39. Takayuki K, Takashi F, Eriko I, Miyuki T, Sadako A-T, Tadashi H (2005) Intracystic papillary carcinoma of the breast in a male patient diagnosed by core needle biopsy: a case report. Breast 14(4):322–324

    Article  Google Scholar 

  40. Tochika N, Takano A, Yoshimoto T, Tanaka J, Sugimoto T, Kobayashi M et al (2001) Intracystic carcinoma of the male breast: report of a case. Surg Today 31(9):806–809

    Article  CAS  PubMed  Google Scholar 

  41. Zeppa P, Mascolo M, Zabatta A, Finelli L, Vetrani A, Palombini L (2003) Aggressive papillary male breast carcinoma on fine-needle cytology sample. Diagn Cytopathol 29(6):360–363

    Article  PubMed  Google Scholar 

  42. Solorzano CC, Middleton LP, Hunt KK, Mirza N, Meric F, Kuerer HM et al (2002) Treatment and outcome of patients with intracystic papillary carcinoma of the breast. Am J Surg 184(4):364–368

    Article  PubMed  Google Scholar 

  43. Fayanju OM, Ritter J, Gillanders WE, Eberlein TJ, Dietz JR, Aft R et al (2007) Therapeutic management of intracystic papillary carcinoma of the breast: the roles of radiation and endocrine therapy. Am J Surg 194(4):497–500

    Article  PubMed  Google Scholar 

  44. Baehner FL, Watson D, Ballard JT, Palmer G, Shak S (2008) Gene expression by standardized quantitative RT-PCR in the special histologic subtypes of estrogen receptor positive invasive breast cancer. Breast Cancer Res Treat (Abstr 3028)

  45. Welsch C, Brown C, Goodrich-Smith M, Van J, Denenberg B, Anderson T et al (1979) Inhibition of mammary tumorigenesis in carcinogen-treated Lewis rats by suppression of prolactin secretion. J Natl Cancer Inst 63:1121–1124

    Google Scholar 

Download references

Acknowledgment

Dr. Pals’s efforts are supported by CBCRP 15IB-0140 (California Breast Cancer Research Program Junior IDEA Award) and NIH K12 2K12CA001727-16A1.

Author information

Authors and Affiliations

  1. Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA

    Sumanta Kumar Pal, Ravi K. Gupta & George Somlo

  2. Department of Pathology, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA

    Sean K. Lau

  3. Department of General Oncologic Surgery, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA

    Laura Kruper, Uzoamaka Nwoye, Benjamin Paz, Eduardo Guzman & Avo Artinyan

  4. Department of Surgery, Loma Linda University Hospital, 11370 Anderson Street Suite 2100, Loma Linda, CA, 91010, USA

    Carlos Garberoglio

  5. Department of Radiology, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA

    Lalit Vora

Authors
  1. Sumanta Kumar Pal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sean K. Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Kruper
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Uzoamaka Nwoye
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carlos Garberoglio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ravi K. Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Benjamin Paz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Lalit Vora
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Eduardo Guzman
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Avo Artinyan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. George Somlo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Sean K. Lau or George Somlo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pal, S.K., Lau, S.K., Kruper, L. et al. Papillary carcinoma of the breast: an overview. Breast Cancer Res Treat 122, 637–645 (2010). https://doi.org/10.1007/s10549-010-0961-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-010-0961-5

Keywords

Search

Navigation