Papillary Lesions of Breast - Limitations of H&E and Pivotal Role of IHC: Single Cancer Centre Study

Abstract

Background–Papillary breast lesions constitute wide spectrum of heterogeneous pathological group. Diagnosis becomes challenging in case of overlapping histomorphological features. Material & methods–Retrospectively 69 papillary lesion were taken into consideration from January 2017 to March 2021.Results – Routine H&E & CK5/6, P63 is used for further differentiation. Cases were divided into three main divisions 1) benign –intraductal papilloma 2) atypical – intraductal papilloma with ADH/ DCIS 3) malignant - Intra ductal papillary carcinoma, encapsulated papillary carcinoma, solid papillary carcinoma & invasive papillary carcinoma. Papilloma comprised of 28 patients between 25-60 years of age & varies in size from 0.6 to 2.8 cm. Papilloma with ADH/DCIS accounted for 8 patients between 34-65 years age group with size of lesion between 0.5 to 3.0 cm. Intraductal papillary carcinoma comprised of 12 patients with size range 1.6 to 4.0 cm in age group of 42 to 65 years. Encapsulated papillary carcinoma comprised of 4 patients with age between 60 to 73 years and lesion size 0.8 to 14 cm. Solid Papillary carcinoma comprised of 10 patients between 39-81 years of age & lesion varies in size from 1.0 to 8.5 cm. Invasive papillary carcinoma comprised of 7 patients between age of 65 to 80 year and size varies between 2.0 to 6.5 cm. Conclusion – Diagnosis of papillary carcinoma is challenging and its classification includes different entities that have specific diagnostic criteria. Due to heterozygosity in morphology of benign, atypical and malignant subtypes, morphological features should be supplemented by IHC for accurate diagnosis.