Solid Papillary Carcinoma Of Breast Research Articles

Non-primary solid malignancies of breast in needle core biopsy: a clinicopathological analysis of 23 cases

Objective: To investigate the accurate diagnosis and differential diagnosis of non-primary solid malignant tumors in breast needle core biopsy. Methods: Twenty-three cases of breast, axilla or neck lymph nodes pathologically diagnosed as non-primary solid malignant tumors were collected at the First Affiliated Hospital of Nanjing Medical University, Nanjing, China from January 2013 to March 2023. The differential diagnoses and diagnostic features were analyzed, based on combining clinical data, histology, and expression characteristics of biomarkers. Results: All patients were female, with age ranging from 29 to 75 years (average 56 years). The average time from the diagnosis of primary tumor to the current diagnosis was 21 months (0 to 204 months).The primary sites included the ovary (9 cases), the lung (5 cases), the gastrointestinal tract (4 cases), the pancreas, intrahepatic bile duct, thyroid gland, nasal cavity and forearm skin (1 case each). No carcinoma in situ was found in any of the cases. The morphological differences were significant among the tumors, but similar to the primary tumors. The tumors of neuroendocrine and female reproductive tract had great morphological and immunophenotypic overlaps with breast cancer. Metastatic lung cancer cells showed obvious atypia and tumor giant cells. The morphology and immunophenotype of metastatic serous carcinoma of female reproductive system might resemble invasive micropapillary carcinoma of the breast. Metastatic adenocarcinoma of the gastrointestinal tract often had features of mucous secretion. Metastatic neuroendocrine tumors were bland in appearance and morphologically similar to solid papillary carcinoma of breast, but negative for ER. TRPS1 was mostly negative (18/23) and variably positive in ovarian (4/9) and intrahepatic bile duct (1/1) tumors. Conclusions: The diagnosis of breast needle core biopsy specimen should be combined with clinical history, imaging study, and careful examination of histological features, such as presence of in situ component, morphological similarity between the primary and metastatic tumors, and using appropriate markers to differentiate the primary from metastatic tumors.

Invasive solid papillary carcinoma of breast mimicking as a benign condition: Rare case report

Invasive papillary carcinomas of breast are rare tumors. They account for approximately 0.5% of all Invasive breast carcinomas. Invasive papillary carcinomas are commonly present in post-menopause women. These tumors lack the myoepithelial cell layer (MCL) within the papillae or at the periphery of the tumor. The diagnosis is difficult due to different clinical and radiological features. Immunohistochemistry (IHC) is really essential to confirming the diagnosis. We are here presenting one index case of a rare variety of invasive papillary carcinoma of the left breast. We present a case of invasive papillary carcinoma of the left breast in a 55-year-old female presented with a retroareolar lump without nipple discharge. Preoperative core biopsy showed fibroadenoma with a papillary configuration.But post-operative histopathological examination revealed it was an invasive papillary carcinoma. Invasive papillary carcinoma of breast even though a rare entity, making a diagnosis is very challenging. Thorough preoperative clinical and radiological examination should be done, so that timely management as well as proper treatment is possible.

Invasive Solid Papillary Carcinoma of breast in an elderly male: a rare entity in an uncommon gender - case report and review of literature

Abstract Introduction/Objective Male breast cancers (MBC) account for less than 1% of all breast cancers. Papillary cancers constitute less than 3% of MBCs. Solid papillary carcinoma (SPC) is a rare subtype of papillary cancer with a solid growth pattern associated with fibrovascular cores. SPC is an indolent disease that typically presents in a post- menopausal woman as a central breast mass. Neuroendocrine differentiation, ER/PR positive status and Her-2 neu negative status are characteristic. SPC can be in situ or have invasive components. SPC is a rare entity in men and so far, approximately less than 40 cases of SPC in men have been discussed in literature. Here, we report a rare case of SPC with multiple invasive foci in an elderly male. Methods/Case Report An 84-year-old white male presented with a painless mass in his left breast. Excision biopsy revealed Solid Papillary Carcinoma. He subsequently underwent a Left Modified Radical Mastectomy with Left Sentinel Lymph Node Excision. The final histopathology report showed a background of SPC with multiple invasive foci with largest focus measuring 2 mm. Margins were negative and lymph nodes were negative for malignancy. The tumor was ER and PR positive, Her-2 neu negative and had a Ki-67 proliferation index of 42%. Negative IHC staining for Cytokeratin AE1/AE3 confirmed the absence of metastatic epithelial cells in the examined lymph nodes. Results (if a Case Study enter NA) N/A Conclusion SPC is an uncommon subtype among the papillary lesions of breast. Furthermore, only a few cases of SPC have been reported in men. Despite its rarity, it has a good prognosis and lymph node positivity, distant metastasis and local recurrence are uncommon. However, there is limited data about SPC with invasive components which may behave like other invasive breast lesions leaving management a dilemma for clinicians. We believe this case will add to the scarce existing literature about invasive SPC in men.

Solid Papillary Carcinoma of Breast: Clinicopathologic Comparison With Conventional Ductal Carcinoma of Breast.

IntroductionSolid papillary carcinoma (SPC) is a distinct rare subtype of breast tumour that often exhibits a neuroendocrine differentiation. Due to the rarity of these tumours, few studies have assessed the clinicopathological features of these tumours. Therefore, in this study, we evaluated the clinical and pathological profiles of SPC and compared the pathologic features with conventional invasive ductal carcinoma (IDC) in our population.MethodsIt was a retrospective cross-sectional study conducted at Liaquat National Hospital and Medical College from January 2013 until December 2019 over seven years. Cases with histological diagnosis of SPC and IDC were included in the study, and clinicopathological characteristics were compared.ResultsWe included 39 cases of SPC in our study diagnosed during the study period. During the same timeline, 634 cases of IDC were reported and therefore included in the study for comparison. The mean age of the patients with SPC was 53.97 ± 12.15 years, and the mean tumour size was 3.42 ± 1.87 cm. Axillary metastasis was noted in 15.4% of cases. 94.9% of cases of SPC were invasive. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2/neu) and synaptophysin positivity was seen in 84.6%, 87.2%, 10.3%, and 59% respectively. Recurrence was noted in 10.3% of cases with 94.9% survival rate. Cases of SPC had significantly lower grade (grade I + II), tumour (T) and nodal (N) stage than IDC. Moreover, the frequency of hormonal receptor expression (ER and PR) was higher, and the frequency of human epidermal growth factor receptor 2 (HER2/neu) expression was lower compared to IDC.ConclusionSPC is a distinct variant of malignant papillary breast tumours with overall better prognostic parameters than IDC. Therefore, it is essential to recognize the histological features of this rare breast tumour.

Solid papillary breast carcinoma arising in the male axilla: A case report

Solid papillary carcinoma is a rare type of breast cancer, with an estimated incidence of 1% of all breast cancer cases. In this case report, a 64 year old male presented with a painless axillary mass. Wide local excision and sentinel lymph node biopsy revealed solid papillary carcinoma. To our knowledge, this is the first case report of a solid papillary male breast cancer diagnosed from an axillary mass in the United States. We discuss solid papillary carcinoma of the breast and relevant literature.

Solid papillary breast carcinoma with reverse polarity, a case report

Solid papillary breast carcinoma with reverse polarity, a case report

Functional and topographic effects on DNA methylation in IDH1/2 mutant cancers

IDH1/2 mutations are early drivers present in diverse human cancer types arising in various tissue sites. IDH1/2 mutation is known to induce a global hypermethylator phenotype. However, the effects on DNA methylation across IDH mutant cancers and functionally different genome regions, remain unknown. We analyzed DNA methylation data from IDH1/2 mutant acute myeloid leukemia, oligodendroglioma, astrocytoma, solid papillary breast carcinoma with reverse polarity, sinonasal undifferentiated carcinoma and cholangiocarcinoma, which clustered by their embryonal origin. Hypermethylated common probes affect predominantly gene bodies while promoters in IDH1/2 mutant cancers remain unmethylated. Enhancers showed global hypermethylation, however commonly hypomethylated enhancers were associated with tissue differentiation and cell fate determination. We demonstrate that some chromosomes, chromosomal arms and chromosomal regions are more affected by IDH1/2 mutations while others remain resistant to IDH1/2 mutation induced methylation changes. Therefore IDH1/2 mutations have different methylation effect on different parts of the genome, which may be regulated by different mechanisms.

Solid papillary carcinoma of breast; a detailed clinicopathological study of 65 cases of an uncommon breast neoplasm with literature review.

Solid papillary carcinoma (SPC) is an uncommon breast tumor whose prognosis depends on invasive component. We studied clinicopathological features of SPC by reviewing 65 cases. Invasive component was seen in 75.4% cases. Almost all tumors with grade III nuclei had invasive component. Mean patients' age of invasive tumors was significantly higher than that of non-invasive tumors (P=.036). All patients were alive and disease free except for a single patient who developed distant metastasis and died of disease. SPC have excellent clinical course. Careful search for invasive component is mandatory, especially in tumors with older patient's age and higher nuclear grade.

Breast Tumor Resembling the Tall Cell Variant of Papillary Thyroid Carcinoma: Molecular Characterization by Next-Generation Sequencing and Histopathological Comparison With Tall Cell Papillary Carcinoma of Thyroid

Recent publications have brought attention to the histopathological, immunohistochemical, and molecular aspects of the rare breast tumor resembling the tall cell variant of papillary thyroid carcinoma (BrTC). Nine archived cases of this entity were retrieved, reviewed, and compared with randomly selected tall cell variants of papillary thyroid carcinoma (ThTC). Seven of the BrTC cases as well as 5 cases of solid papillary carcinoma of breast were analyzed by Oncomine next-generation sequencing. BrTC and ThTC were histologically distinguishable by the presence of solid architecture, luminal histiocytes, and reverse polarity in the former, and psammoma bodies, giant cells, and optically clear nuclei in the latter. Sequencing revealed IDH2 R172 single-nucleotide variants in all 7 BrTCs, 6 of which had concurrent PIK3CA mutations. None of the conventional solid papillary carcinomas demonstrated IDH2 mutation. BrTC bears superficial resemblance to other papillary tumors but is unique in terms of histology and molecular profile.

Solid Papillary Carcinoma of the Breast: Magnetic Resonance Mammography, Digital Mammography, and Ultrasound Findings.

The aim of this study was to investigate the MR mammography (MRM), digital mammography (DM), and ultrasound (US) findings of solid papillary carcinoma (SPC) of breast and to raise awareness of this rare breast tumor. Thirty patients diagnosed with breast SPC (age range, 21-72; mean age, 60.27 years) from January 2013 to August 2015 were enrolled. Their clinical presentation and MRM, DM, and US findings were retrospectively reviewed. All patients underwent both MRM and US, and 20 of them underwent DM. The research primarily investigated MRM features correlated with clinicopathological characteristics. Of all the patients, 13 were pure SPC in suit, whereas 17 were microinvasive SPC. The detection rates of US, DM, and magnetic resonance imaging for SPC were 30%, 50%, and 100%, respectively, and there were no specific imaging features on DM and US. The most common MRM appearances were located in the retroareolar area (16/30, 53.34%) with T2WI hyperintensity (24/30, 80%) and ductal ectasia (18/30, 60%). Non-mass enhancement of a linear or segmental distribution (17/18, 94.44%) together with clumped enhancement (12/18, 66.66%) and mass with a rim (6/12, 50%) or heterogeneous (6/12, 50%) enhancement were 2 of the typical enhancement features of SPC. Compared with pure SPC, SPC with microinvasive showed larger size of the lesion (t = 1.083, P = 0.026). Although SPC was difficult to detect in both DM and US, MRM gave better detection of this rare tumor. The MRM characteristics of SPC were distinct and highly similar to its clinicopathological features.

Solid papillary breast carcinomas resembling the tall cell variant of papillary thyroid neoplasms (solid papillary carcinomas with reverse polarity) harbour recurrent mutations affecting IDH2 and PIK3CA: a validation cohort.

Solid papillary breast carcinoma resembling the tall cell variant of papillary thyroid neoplasms (BPTC), also known as solid papillary carcinoma with reverse polarity, is a rare histological type of breast cancer that resembles morphologically the tall cell variant of papillary thyroid carcinoma. BPTCs are characterised by IDH2 R172 hotspot somatic mutations or mutually exclusive TET2 somatic mutations, concurrently with mutations affecting PI3K pathway-related genes. We sought to characterise their histology and investigate the frequency of IDH2 and PIK3CA mutations in an independent cohort of BPTCs, as well as in conventional solid papillary carcinomas (SPCs). Six BPTCs, not previously analysed molecularly, and 10 SPCs were reviewed centrally. Tumour DNA was extracted from microdissected histological sections and subjected to Sanger sequencing of the IDH2 R172 hotspot locus and exons 9 and 20 of PIK3CA. All six BPTCs were characterised by solid, papillary and follicular architecture with circumscribed, invasive tumour nodules composed of epithelial cells with reverse polarity. IDH2 mutations were identified in all six BPTCs (three R172S, two R172T and one R172G), four of which also harboured PIK3CA mutations (two H1047R, one Q546K and one Q546R). By contrast, all SPCs lacked IDH2 mutations, while one of 10 harboured a PIK3CA mutation (H1047R). We validated the presence of IDH2 R172 hotspot mutations and PIK3CA hotspot mutations in 100% and 67% BPTCs tested, respectively, and documented absence of IDH2 R172 mutations in SPCs. These findings confirm the genotypical-phenotypical correlation reported previously in BPTC, which constitutes an entity distinct from conventional SPC.

Analysis of the clinicopathological characteristics and prognosis in 674 cases of breast intraductal papillary tumor

Objective: Breast intraductal papillary tumors are clinically common diseases derived from the ducts. The aim of this study is to investigate the clinicopathological characteristics of intraductal papillary tumors and risk factors for carcinogenesis. Methods: The clinicopathological data of 674 patients with breast intraductal papillary tumors, who underwent surgery in the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences from January 2010 to July 2015, were retrospectively analyzed. Results: The median follow-up time was 46 months. The 674 cases were classified into 547 intraductal papilloma, 88 cases of intraductal papillary carcinoma, 32 cases of intracystic papillary carcinoma, and 7 cases of solid papillary carcinoma of breast. After a median follow-up time of 46 months, 13 out of 547 (2.4%) intraductal papillomas had local recurrence in the original dissected quadrat, another 10 cases developed breast cancer in the original dissected quadrat. The 3-year recurrence-free survival rates in intraductal papilloma and intraductal papilloma accompanied with atypical ductal hyperplasia were 97.7% and 93.5%, respectively, the recurrence-free survival curves showed a significant difference (P=0.011). Multivariate analysis indicated that atypical ductal hyperplasia was a major prognostic factor affecting the recurrence-free survival of intraductal papilloma (RR=0.183, 95%CI=0.054 to 0.777, P=0.020). Four cases (3.1%) of intraductal papillary carcinoma had local recurrence. The logistic analysis showed that patient aged >45 years, clinical manifestations of a breast lump, maximum tumor diameter greater than 2 cm are possible clinical manifestation of malignant breast intraductal papillary tumors (RR=1.735, 95%CI=1.007-2.990, P=0.047; RR=2.849, 95%CI=1.207-6.711, P=0.017; RR=3.792, 95%CI=2.162-6.653, P<0.001). Conclusions: Intraductal papillary tumors have a certain recurrence rate. Age, clinical features and tumor size may be predictive factors of intraductal papillary carcinoma.

Solid Papillary Carcinoma of the Breast: A Review

Solid papillary carcinoma of breast is a low-grade tumour originating in the ductal epithelium. It is commonly seen in post-menopausal women and account for

An Unusual Case of High Grade Triple Negative Intracystic Solid Papillary Carcinoma of Breast with Invasive Component

Background: Intracystic (encysted) papillary carcinoma (IPC) is a rare distinct entity of breast cancer, usually asymptomatic, sometimes presented as breast mass or nipple discharge. It shows benign appearance on imaging. Ultrasonography shows pure cyst or mixed image, sometime solid mass. Pathologically can be divided into pure form, or associated with ductal carcinoma in situ (DCIS) or invasive carcinoma. It is considered as noninvasive or minimally invasive, because there is no infiltrating growth pattern and metastases are rare. Traditionally considered to lack a myoepithelial layer, it has favorable prognosis even with invasion. Stromal invasion found in 92%. In case of high grade variant which diagnosed by high nuclear grade and high mitotic activity, usually triple negative and p53+ as we have in our case? Case presentation: We report a case of breast cancer that occurred in 42-year-old woman presented with a painless lump in the left breast, FNA yielded hemorrhagic fluid. Patient underwent wide local Excision. The final histopathological finding shows encapsulated/intra cystic carcinoma, papillary variant with high grade features, as defined by nuclear pleomorphic and increased mitotic activity. This tumor is also hormone receptor and HER-2- negative, and is associated with stromal invasion by high grade NOS. Conclusion: High grade encapsulated papillary carcinoma is extremely rare variant, usually associated with invasive component; morphologically it is more aggressive. It behaves like its invasive counterpart.

A clinicopathologic analysis of 31 patients with solid papillary carcinoma of breast

Objective To study the clinicopathologic features, immunophenotype, diagnosis and differential diagnosis of solid papillary carcinoma (SPC) of breast. Methods A retrospective study was performed to analyse the clinicopathologic features and immunophenotype of 31 cases of SPC with or without invasion. The cytokeratins (CK), myoepithelial markers, neuroendocrine markers, proliferation marker Ki-67, estrogen receptor (ER), progesterone receptor (PR), HER2, ect were detected by immunohistochemical staining, and HER2 was detected by FISH. All patients were followed up. Results All the patients were females with a mean age of (67.0±12.5) years. The presenting symptom was a painless mass with or without nipple discharge. In 19 cases who had undergone axillar lymph node dissection, only one metastasis was observed. General observation showed that tumors had substantive and nodular lesions, accompanied by cyst formation. Microscopy examination showed that tumors had swell and substantive nodules with only fine fiber vascular axis, and lacked obvious nipples and screen structure. The cells were lack of atypia,adhesive in cells nest. 20 patients were accompanied by mucus secretion. Immunohistochemical study showed that the tumor cells expressed CK8/18, ER, PR, but didn't express basal cell CK5/6, 34β12. The positive rates of CK5/6, 34β12, p63 were 3.23 % (1/31), 9.68 % (3/31), 6.45 % (2/31) in the myoepithelial layers of axis of papillary, and were 19.25 % (6/31), 38.71 % (12/31), 16.13 % (5/31) in peripheral cell nests and tumors, respectively. The positive rates of CgA, Syn, NSE, Cd56 were 83.87 % (26/31), 87.10 % (27/31), 93.55 % (29/31), 90.32 % (28/31), respectively. The staining of HER2 oncoprotein was negative mostly, and the FISH detection outcome of 15 cases were all negative. The average positive index of Ki-67 was 4.12 %. 28 cases (90.23 %) received follow-up, only 1 patient died, and the rest patients were without tumor recurrence or metastasis. Conclusions SPC of breast, a rare pathologic type, usually occurs in old females. The diagnosis depends on pathological characteristics and its unique immune phenotypic characteristics. SPC of breast has close relationship with mucinous carcinoma and neuroendocrine carcinoma,with a relatively inert biological behavior. Key words: Solid papillary carcinoma of breast; Clinicopathologic; Immunophenotype; In situ hybridization, fluorescence; Prognosis

Solid papillary carcinoma of the breast: A special entity needs to be distinguished from conventional invasive carcinoma avoiding over-treatment

IntroductionSolid papillary carcinoma of the breast, a newly-defined entity, is poorly recognized, and its nature and management is still debated. Material and methodsEleven cases of pure solid papillary breast carcinoma in our archive and 253 cases reported in previous literature were retrospectively analyzed for their clinicopathological features and outcomes. ResultsThe eleven cases occurred in elderly females. Grossly, all tumors were well-circumscribed and typically composed of solid papillary nodules. The tumor cells were bland-looking with low-grade atypia and mitoses < 5/10HPF. Immunophenotypically, all eleven cases showed positivity for ER and PR, negativity for CK5/6 and HER2, and a low proliferative index of Ki67. Five cases showed scattered positivity for myoepithelial marker p63, and four cases were positive for CK5/6 and CD10 around the nodules, whereas the other cases were completely negative for all myoepithelial markers. Five cases expressed the neuroendocrine marker synaptophysin, and six cases expressed chromogranin. In nine cases, mastectomy and axillary lymph nodes excision were performed, and only one showed micrometastasis in an axillary lymph node. There was no local recurrence or distant metastasis or breast carcinoma related-death during the follow-up periods of 50 months. Out of 253 solid papillary breast carcinomas reported in literature, the percentage of axillary lymph node metastasis was 4/136 (3%), with rare local recurrences and distant metastasis; only three patients died of breast carcinoma. ConclusionSolid papillary carcinoma of the breast is a rare entity with distinctive clinicopathological features and excellent prognosis and should be distinguished from conventional breast carcinoma to avoid over-treatment.

Imaging and Histopathology Correlation of Solid Papillary Carcinoma of the Breast : A Review of Four Cases

Solid papillary breast carcinoma is a rare type of breast carcinoma. We present four cases which highlight the radiological and histological findings of solid papillary carcinoma. Mammogram supplemented with ultrasound played an important role in detecting solid papillary carcinomas which usually presents as intraductal lesions or intracystic mass with Doppler signal. Excision biopsy is a better option than core biopsy as the latter modality may not be representative and the diagnosis of solid papillary breast carcinoma may be missed.

Invasive solid papillary breast carcinoma with papillary metastasis

HistopathologyVolume 50, Issue 4 p. 515-516 Invasive solid papillary breast carcinoma with papillary metastasis J D Coyne, J D Coyne Department of Pathology, Wythenshawe Hospital, Manchester, UKSearch for more papers by this author J D Coyne, J D Coyne Department of Pathology, Wythenshawe Hospital, Manchester, UKSearch for more papers by this author First published: 06 February 2007 https://doi.org/10.1111/j.1365-2559.2007.02600.xCitations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume50, Issue4March 2007Pages 515-516 RelatedInformation

Clinicopathologic study of solid papillary carcinoma of breast

To study the clinicopathologic features and immunophenotype of solid papillary carcinoma (SPC) of breast. Clinical and pathologic features of 21 cases of SPC, with or without stromal invasion, were analyzed. Immunohistochemical study (LSAB method, for cytokeratins, myoepithelial markers, chromogranin A, synaptophysin, Ki-67, estrogen receptor, progesterone receptor, c-erbB-2 and pS2) and alcian blue staining were performed. All the patients were females with a mean age of 66.1 years. The clinical features were similar to those of classic papillary tumor. Metastasis was not observed in patients who had undergone axillary lymph node dissection. Histologically, the tumor displayed solid papillary growth pattern, with mucin production demonstrated in 19 cases. The tumor cells were oval, polygonal, spindled or signet ring-like and contained mildly to moderately pleomorphic nuclei. The mitotic count measured less than 5 per 10 high-power fields in 15 cases. Seven cases contained foci of invasive carcinoma which showed similar cytologic features as those of the in-situ component. Immunohistochemical study showed that the tumor cells expressed CK8 but not basal cell cytokeratin. Positivity for smooth muscle actin-alpha, calponin and p63 was demonstrated in the myoepithelial layers of fibrovascular cores, as well as around the expanded ductolobular units. Most cases also showed cytoplasmic positivity for chromogranin A (88.2%) and synaptophysin (82.4%). The proliferation index, as highlighted by Ki-67 immunostain, was 8.1%. The tumor expressed estrogen receptor, progesterone receptor and pS2. The staining for c-erbB-2 oncoprotein was negative. Follow up of 16 patients showed no evidence of recurrence or metastasis. SPC predominantly affects elderly females and has distinctive pathologic features and immunophenotype. Some cases of SPC are associated with mucinous and neuroendocrine components. Follow-up data suggest that SPC often carries an indolent clinical behavior and favorable prognosis.