Intracystic Papillary Carcinoma Research Articles

MR imaging findings of benign and malignant circumscribed breast masses: part 2. Cystic circumscribed masses

The purpose of our study was to review the magnetic resonance (MR) imaging findings and pathological characteristics of benign and malignant cystic circumscribed breast masses. This article reviews the MR imaging findings of cystic circumscribed breast masses. Intracystic papillomas typically show a single mural nodule with a washout enhancement pattern. Intracystic papillary carcinomas show multiple mural nodules or grow as a solid mass that obliterates the cystic space with a washout enhancement pattern. Despite the MR imaging findings, however, many circumscribed breast masses are impossible to differentiate without performing a biopsy.

Breast Intracystic Papillary Carcinoma: An Update

Intracystic papillary carcinoma (IPC), a breast tumor mainly occuring in the elderly, has long been considered as a variant of ductal carcinoma in situ (DCIS). This is now debated since metastatic cases have been reported. In this study, surgical pieces of 20 IPCs were reassessed, and markers of myopepithelial layer (p63, CD10 and Smooth Muscle Actin) as well as estrogen receptors (ER) and progesterone receptors (PgR) and C-erb-B2 oncoprotein expression were systematically performed and quantified. In 10 cases, an associated unequivocal invasive component was found. In all 20 cases, no myoepithelial layer was found. Eighteen tumors were ER positive, 14 were PgR positive. Moreover, none of the tumors over-expressed C-erb-B2 oncoprotein. Therefore this study showed that in all cases of IPC there were microscopic features of invasive carcinoma despite good clinical prognostic indicators, and that precise characterization of tumors requires extensive paraffin embedding of surgical pieces.

Intracystic papillary carcinoma of the breast: one of the youngest patient in the literature

Intracystic papillary carcinoma of the breast: one of the youngest patient in the literature

Intracystic papillary carcinoma of the male breast: a case report and review of the literature

Carcinoma of the male breast is an infrequent and poorly understood disease (Sinha et al. in Ann R Coll Surg Engl 88(5):W3-W5, 2006). It differs from female breast cancer in both demographic and histopathological characteristics. Herein we describe a case of intracystic papillary carcinoma in situ in a male breast with a review of the literature. Although rare, in situ carcinoma constitutes a larger proportion of male than female breast cancer in a non-screened population. It is characteristically of the papillary and micropapillary subtype. Intracystic papillary carcinoma is a noncomedo intraductal carcinoma constituting about 0.5% of female breast cancers and is associated with a slightly inferior prognosis than other noncomedo intraductal carcinomas (Lefkowitz et al. in Hum Pathol 25:802-809, 1994).

Intracystic invasive papillary carcinoma of the male breast with analyses of loss of heterozygosity on chromosome 16q

A 64-year-old man noticed a right subareolar mass in May 2005. On physical examination, an oval-shaped, well-circumscribedthe tumor (6.0 x 5.5 cm in size) was located just beneath the right nipple. The tumor was elastic, firm and freely movable. Neither axillary nor supraclavicular lymph nodes were palpable. Mammography demonstrated a 5 x 5-cm, relatively distinct and dense mass without microcalcifications or spiculations. There were no findings of concurrent gynecomastia. Ultrasonography revealed a large multilocular cyst with a mural hypoechoic protruding lesion exhibiting wide-based morphology with an irregular margin. On contrast-enhanced computed tomography, the inner lesion enhanced, but direct invasion of the tumor to the major pectoral muscle was not found. An intracystic papillary lesion, possibly papillary carcinoma, was suspected. In December 2007, wide excision of the tumor was performed. On histopathological examination, the tumor had a papillary pattern with a small cribriform component in the cystic wall with microinvasion of the stroma. Marginal status was negative. The final diagnosis of the disease was a microinvasive intracystic papillary carcinoma of low grade without axillary lymph node metastases. Immunohistochemically, estrogen receptor and progesterone receptor were both positive, but negative for HER-2 protein. No LOH on 16q could be detected. The prognosis of the disease was unclear; however, the malignant potential of this condition may be more clearly determined by studying the LOH on chromosome 16q.

Intracystic papilloma of the breast forming a giant cyst

Intracystic tumors of the breast prove to benign more often than malignant, and most intracystic lesions are benign papillomas. Generally, the cyst with intracystic papilloma of the breast is small, and there are few cases of intracystic papilloma of the breast forming a giant cyst in the literature. We report the case had the intracystic papilloma of the breast with a giant cyst (diameter of 15.0 cm). Imaging examinations showed two intracystic components in the cyst, and suggested that they were malignancy. Cytological examinations revealed no malignant cell. In spite of many aspirations of the cyst fluid, the size was not changed finally. The surgical resection was performed, and histological examination revealed two intracystic papillomas. In review of the literatures, it is difficult to distinguish between intracystic papilloma and intracystic papillary carcinoma by imaging or cytologic examinations preoperatively. Surgery should be recommended to confirm diagnosis and treatment.

Intracystic papillary carcinoma in a male as a rare presentation of breast cancer: a case report and literature review

IntroductionThe term "intracystic papillary ductal carcinoma in situ" has recently changed and is now more appropriately referred to "intracystic papillary carcinoma". Intracystic papillary carcinoma in men is an extremely rare disease with only a few case presentations published in the literature so far.Case presentationWe discuss a case of a 44-year-old Caucasian man with an intracystic papillary carcinoma treated with simple mastectomy, sentinel lymph-node biopsy and contralateral risk-reducing mastectomy. These were followed by adjuvant radiotherapy of the breast.ConclusionTriple assessment (i.e. clinical examination and radiological and histological assessment) with a high level of clinical suspicion is necessary to diagnose intracystic papillary carcinoma in men due to its rarity. Furthermore, genetic testing and risk-reducing mastectomy should also be considered in cases of a strong family history for male breast cancer.

The role of immunohistochemistry in the differential diagnosis of papillary lesions of the breast

Papillary lesions of the breast represent a heterogeneous group with differing biological behaviour. Correct diagnosis is crucial but may be difficult, as many benign and malignant papillary lesions have similar...

Experience with Intracystic Papillary Carcinoma of the Breast at a Single Institute in Korea

Intracystic papillary carcinoma (IPC) of the breast is a rare entity, which can be associated with ductal carcinoma in situ (DCIS) or an invasive carcinoma. There have been only limited reports describing IPC in Korea and the incidence among breast cancer cases in Korea has not yet been report- ed. From a database of 7,109 breast cancer cases treated surgically at Samsung Medical Center, we could only identify four IPC cases (0.056%). We also found that there are some differences between the clinicopathological characteristics of our cases and the alleged characteristics of IPC as reported from Western countries, such as a relatively young age of onset, small tumor size and various expression levels of hor- monal receptors. We suspect this very low incidence may be caused by a true rarity of IPC in women in Korea or may be due to a lack of clinical interest for IPC. Upon presentation of our experience with IPC, we suggest the diagnosis for this rare disease entity needs to be reappraised.

Clinical and pathological features of intracystic papillary carcinoma of the breast

To evaluate the clinicopathological features of intracystic papillary carcinoma (ICPC), which have not been established given its rarity and lack of standard diagnostic criteria. We reviewed the clinicopathological findings and treatment outcomes of 14 patients with ICPC diagnosed between 2002 and 2006. Intracystic papillary carcinoma was diagnosed by fine-needle aspiration biopsy in three patients and by core-needle biopsy in six patients. A preoperative diagnosis was not made in five patients. Three patients underwent magnetic resonance imaging preoperatively, which helped to differentiate benign tumors and maintain free surgical margins. The final pathological diagnosis was invasive carcinoma in 2 (14.2%) of the 14 patients. The patients were followed up for 1-72 months, during which time only one died, of a cancer-unrelated cause. Our results show that ICPC is more difficult to diagnose than common breast cancer preoperatively. Excisional biopsy was necessary when fine-needle aspiration and core-needle biopsy could not provide a diagnosis. Magnetic resonance imaging is helpful to differentiate a benign tumor from invasive disease.

Intracystic papillary carcinoma associated with ductal carcinoma in situ in a male breast: a case report

IntroductionIntracystic papillary carcinoma represents a small distinctive subgroup of noninvasive breast cancer, accounts for <0.5% of breast malignancies and is extremely rare in men, it was originally reported as a localized non-invasive carcinoma, but is usually associated with ductal carcinoma in situ around the main tumor or invasive carcinoma.Case presentationWe report a case of 50-year-old man with intracystic papillary carcinoma in man with ductal carcinoma in situ who underwent a tumorectomy following by a radical Patey intervention (Halsted).ConclusionNowadays, there is still no clear consensus regarding optimal treatment of intracystic papillary carcinoma. Most papers reinforce the importance of an adequate surgical margin in conservative treatment. Surgeons must pay much attention to the potential for ductal carcinoma in situ around the tumor when selecting the operative procedure.

Intracystic papillary carcinoma

Intracystic papillary carcinoma (IPC) is an uncommon breast neoplasm. To the authors' knowledge there are limited data regarding its epidemiology and only small studies focusing on outcomes. By using a large, population-based database, this study aimed to identify specific characteristics of patients with IPC, investigate its natural history, and determine its long-term prognosis. The California Cancer Registry (CCR), a population-based registry, was reviewed from the years 1988 through 2005. The data were analyzed with regard to patient sex, age at presentation, tumor stage, and overall survival. Cumulative relative actuarial survival was determined using a Berkson-Gage life table method. The CCR classifies IPC as either in situ (CIS) or invasive, as determined by the local pathologist. A total of 917 cases of IPC were identified. Approximately 47% of cases (n = 427) were CIS, whereas 53% of cases had invasion (n = 490). The majority of the invasive cases were localized at the time of diagnosis (89.6%; n = 439). At 10 years, patients with CIS and invasive disease had a similar relative cumulative survival (96.8% and 94.4%; P = .18). IPC is a rare disease. There is no apparently significant difference in the long-term survival of patients in the 2 histologically derived subgroups of IPC. There is an excellent prognosis for patients diagnosed with IPC regardless of whether the tumor is diagnosed as in situ or invasive. Clinicians should keep this in mind when planning surgical and adjuvant treatments. Sentinel lymph node biopsy may be a prudent way to evaluate axillary involvement in patients with IPC.

Clinicopathologic study of intracystic papillary carcinoma of the breast

To elucidate the clinicopathologic features, immunophenotype and differential diagnosis of intracystic papillary carcinoma (IPC). The clinical and pathological characteristics of 14 cases of breast IPC were studied. Immunohistochemical study of SMA, MSA, ER, PR, p63, AE1/AE3, 34betaE12 and CK5/6 was performed using Envision method. The age of IPC patients ranged from 42 to 79, with a mean age of 65.4 years. A palpable mass was the most common symptom. There were two morphological features: (1) Slender papillae lined by tall columnar epithelial cells which were present directly on the fibrovascular cores without an intervening myoepithelial cell layer (9 cases). (2) The proliferation may assume a cribriform architecture with rigid, punched-out regular spaces or a solid glandular pattern, studded with fibrovascular cores (5 cases). Low nuclear grade is typically seen. Among the 14 cases of IPC, 11 were of pure type. Ductal carcinoma in situ (DCIS) in adjacent ducts was found in one case, and invasive carcinoma was found in two cases. Immunohistochemical results showed that the tumor cells were homogenously strongly positive for ER and PR, but were negative or focally and weakly positive for CK5/6 and 34betaE12. Myoepithelial cell staining was negative within the tumor; and was diminished or scattered at the periphery of the tumor. IPC is a rare entity that usually arises in older women. It is specific enough in its clinical presentation and morphologic appearance to warrant distinction from other breast lesions.

Intracystic Papillary Carcinoma in the Male Breast: A Case Report

남성유방암은전체유방암의1% 미만으로매우드물게발생하 며조직학적인분류와이에따른발생빈도는여성유방암과비슷 하다.(1) 유방의 유두상 암종(papillary carcinoma)은 여성 유방 암에서 약 0.3-2%를 차지하는 비교적 드문 종양이며 남성 유방 암에서는약5-7.5%를차지하여여성보다는전체남성유방암에 서 차지하는 비율이 약간 높다.(1) 남성 유방암에서 관상피내암 (ductal carcinoma in situ)은 약 7%를 차지하며 대부분은 유두 상암종이라고한다.(2)낭종내유두상암종(intracystic papillary carcinoma)은 비침습성 유두상 암종의 변형으로 남성에서는 매 우드물게발생하며예후가좋다. 저자들은49세남자의우측유 방에서발생한낭종내유두상암종을경험하여문헌고찰과함께 보고하는바이다. 증 례

Intracystic papillary carcinoma associated with ductal carcinoma in situ in a male breast

Intracystic papillary carcinoma associated with ductal carcinoma in situ in a male breast

Intracystic Papillary Carcinomas of the Breast: A Reevaluation Using a Panel of Myoepithelial Cell Markers

Intracystic Papillary Carcinomas of the Breast: A Reevaluation Using a Panel of Myoepithelial Cell Markers

Therapeutic management of intracystic papillary carcinoma of the breast: the roles of radiation and endocrine therapy

Background The role of radiation and endocrine therapy in the treatment of intracystic papillary carcinoma (IPC) remains unclear. The aim of the current study was to review the management of IPC in order to determine factors associated with use of adjuvant therapies. Methods A retrospective review of our surgical and pathology databases from 1995–2006 identified 45 women with IPC. These patients were further divided into those with pure IPC (n = 21), IPC with associated ductal carcinoma in situ (DCIS) (n = 18), and IPC with associated microinvasion with or without DCIS (n = 6). Patient characteristics were compared between groups using the chi-square test. Results Patients with IPC and microinvasion were more likely to undergo an axillary staging procedure (6/6, 100%) compared to patients with pure IPC (6/21, 29%) or IPC with DCIS (5/18, 28%) ( P < .001). Patients with pure IPC were less likely to have radiation therapy than patients with IPC and DCIS or microinvasion ( P < .001). However, within the subset of patients with pure IPC, women less than 50 years of age were more likely to have radiation therapy than those older than 50 years ( P < .001). Patients with IPC and DCIS or microinvasion had significantly increased use of endocrine therapy versus patients with pure IPC ( P < .01). Conclusions In our patient population, those patients with IPC and associated DCIS or microinvasion are treated with adjuvant radiation and endocrine therapy on the basis of this associated pathology. The use of adjuvant radiation and/or endocrine therapy should be considered in patients with pure IPC who are of young age (<50 years).

A case of intracystic papillary carcinoma accompanying widespread ductal carcinomain situ

A 39-year-old Japanese woman noticed a right breast tumor in July 2004. Mammography (MMG) demonstrated an oval tumor without calcification. Dynamic Magnetic Resonance Imaging (D-MRI) demonstrated a high-intensity mass on T2-weighted images, showing mild enhancement during the arterial phase and persistent enhancement during the arterial late phase. Core needle biopsy revealed papillary carcinoma suggestive of Intracystic Papillary Carcinoma (IPC). Auchincloss operation was performed following a partial mastectomy, as the surgical margin after partial mastectomy was positive for carcinoma. Histopathologic mapping of her right breast revealed wide and extensive intraductal spread of DCIS around the IPC. IPC was originally reported to be a localized non-invasive mammary carcinoma. But approximately, half of IPC cases are associated with invasive carcinoma or DCIS beyond the tumor. Careful selection of operative procedure is needed after localized non-invasive IPC or IPC associated with DCIS around the main tumor or invasive carcinoma is diagnosed.

Metastatic Potential of Encapsulated (Intracystic) Papillary Carcinoma of the Breast: A Report of 2 Cases With Axillary Lymph Node Micrometastases

Intracystic papillary carcinoma of the breast has rarely been reported to be associated with metastases. Presented are 2 cases, both of which showed micrometastatic carcinoma in axillary lymph nodes; neither demonstrated stromal invasion. Nearly complete absence of a myoepithelial cell layer around the periphery of the lesions was noted. One case showed 3 separate foci of micrometastatic carcinoma in 1 of 3 sentinel lymph nodes; the second showed micrometastases in 2 of 11 axillary lymph nodes. The clinical significance of micrometastases in lymph nodes associated with intracystic papillary carcinoma is unknown. The term encapsulated papillary carcinoma has been proposed to name papillary carcinomas that are surrounded by a fibrous rim, but which show a scant or absent myoepithelial cell component. The current 2 cases offer evidence to support the use of this term for particularly large encysted lesions. Sentinel lymph node biopsy may be prudent in such cases.

Intracystic Papillary Carcinomas of the Breast: A Reevaluation Using a Panel of Myoepithelial Cell Markers

Intracystic Papillary Carcinomas of the Breast: A Reevaluation Using a Panel of Myoepithelial Cell Markers