Papillary carcinomas of the breast (PCB), also termed malignant papillary carcinomas of the breast, are rare forms of the breast cancers.[1] The World Health Organization (2019) classified papillary neoplasms (i.e. benign or cancerous tumors) of the breast into 5 types: intraductal papilloma, papillary ductal carcinoma in situ (PDCIS), encapsulated papillary carcinoma (EPC), solid-papillary carcinoma (SPC), and invasive papillary carcinoma (IPC). The latter four carcinomas are considered here; intraductal papilloma is a benign neoplasm.[2] The World Health Organization regarded solid papillary carcinoma as having two subtypes: in situ and invasive SPC.[3]
PCB develop from the epithelial cells that line the outer surfaces of ducts leading from exocrine glands or organs, blood vessels, or inner surfaces of the cavities in many internal organs. PCB are carcinomas derived from the epithelial cells of mammary gland ducts.[1] They are a clinically, histologically, and biologically heterogeneous group of breast cancers that are often difficult to distinguish from each other as well as from other papillary breast lesions.[4] The identification of PBS tumors may require the input of breast pathologists familiar with papillary lesions of the breast.[3][5][6][7][8]
The four types of PCB are defined and diagnosed in part by several of their microscopic features including: 1) the presence of tumor invasion into adjacent normal tissues; 2) the presence and location of myoepithelial cells, i.e. cells that normally rest on the basement membrane of mammary gland ducts and function to contract and thereby expel milk from mammary glands[3] (these cells are identified by immunohistochemistry staining tumor tissue with, e.g. cytokeratin 5/6 antibodies that detect two markers of myoepithelial cells, cytokeratin 5 and keratin 6A);[6]3) the presence of a thick fibrous capsule enclosing the carcinoma;[6]4) the presence of areas of neuroendocrine differentiation, i.e. sites of accumulated neoplastic cells with features combining those of nerve and hormone-producing cells including in particular the presence of neurosecretory granules, i.e. cytoplasmic granules about 180 nanometers in diameter that are found in neurons and secretory cells;[9] and 5) the presence of signet ring-shaped cells bearing mucin-containing granules.[10]
^ abHuang K, Appiah L, Mishra A, Bagaria SP, Gabriel ME, Misra S (May 2021). "Clinicopathologic Characteristics and Prognosis of Invasive Papillary Carcinoma of the Breast". The Journal of Surgical Research. 261: 105–112. doi:10.1016/j.jss.2020.12.026. PMID 33422900. S2CID 231575839.
^Athanasiou A, Khomsi F, de Joliniere B, Feki A (2021). "Encapsulated Papillary Carcinoma: A Case Report and Review of the Literature". Frontiers in Surgery. 8: 743881. doi:10.3389/fsurg.2021.743881. PMC 8854492. PMID 35187043.
^ abcBrogi E, Krystel-Whittemore M (January 2021). "Papillary neoplasms of the breast including upgrade rates and management of intraductal papilloma without atypia diagnosed at core needle biopsy". Modern Pathology. 34 (Suppl 1): 78–93. doi:10.1038/s41379-020-00706-5. PMID 33106592. S2CID 225072361.
^Kulka J, Madaras L, Floris G, Lax SF (January 2022). "Papillary lesions of the breast". Virchows Archiv. 480 (1): 65–84. doi:10.1007/s00428-021-03182-7. PMC 8983543. PMID 34734332.
^Tariq MU, Idress R, Qureshi MB, Kayani N (December 2020). "Encapsulated papillary carcinoma of breast; a clinicopathological study of 25 cases and literature review with emphasis on high grade variant". Annals of Diagnostic Pathology. 49: 151613. doi:10.1016/j.anndiagpath.2020.151613. PMID 32911448. S2CID 221622997.
^ abcRoss DS, D'Alfonso TM (March 2022). "Papillary Neoplasms of the Breast: Diagnostic Features and Molecular Insights". Surgical Pathology Clinics. 15 (1): 133–146. doi:10.1016/j.path.2021.11.009. PMID 35236629. S2CID 246465764.
^Tay TK, Tan PH (June 2021). "Papillary neoplasms of the breast-reviewing the spectrum". Modern Pathology. 34 (6): 1044–1061. doi:10.1038/s41379-020-00732-3. PMID 33462367. S2CID 231639987.
^Morgan S, Dodington D, Wu JM, Turashvili G (2021). "Solid Papillary Carcinoma and Encapsulated Papillary Carcinoma of the Breast: Clinical-Pathologic Features and Basement Membrane Studies of 50 Cases". Pathobiology. 88 (5): 359–373. doi:10.1159/000517189. PMID 34265775. S2CID 235960649.
^Tsang JY, Tse GM (June 2021). "Breast cancer with neuroendocrine differentiation: an update based on the latest WHO classification". Modern Pathology. 34 (6): 1062–1073. doi:10.1038/s41379-021-00736-7. PMID 33531618. S2CID 231745657.
^Nassar H, Qureshi H, Adsay NV, Volkanadsay N, Visscher D (April 2006). "Clinicopathologic analysis of solid papillary carcinoma of the breast and associated invasive carcinomas". The American Journal of Surgical Pathology. 30 (4): 501–7. doi:10.1097/00000478-200604000-00011. PMID 16625097. S2CID 30657952.
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