Carcinoma papilar encapsulado de mama

Abstract

Encapsulated carcinoma is an infrequent tumour of the breast, which is surrounded by a fibrous capsule and forms part of the spectrum of papillary breast lesions. Diagnosis is histopathological and these tumours have a favourable prognosis. These tumours are a rare clinicopathological entity and represent a diagnostic challenge. Negative basal membrane markers and the absence of myoepithelial cells may lead to over-diagnosis and over-treatment. If allowed by the breast-tumour ratio, treatment consists of sectoral resection. Sentinel node analysis is controversial. We present the case of a postmenopausal woman with a palpable nodule in the left breast, immunogeneologically classified as BI-RADS 4 c. Histological study of the core biopsy specimen showed invasive ductal papillary carcinoma.Sector tumoural resection was performed with oncological margins and sentinel node study. The definitive histopathological diagnosis was encapsulated papillary carcinoma with microinvasion, associated with a focus of low-grade ductal carcinoma in situ. Treatment was completed with radiotherapy and adjuvant hormone therapy. Encapsulated papillary carcinomas represent 0.2% to 2% of breast tumours. Histological diagnosis is difficult, both with cytological and histological samples, and is based on the absence of myoepithelial cells, both in the periphery and inside the tumour. Treatment is surgical and consensus is lacking on the indication for adjuvant therapy. Most authors, however, report that these tumours respond well to radiotherapy.