Papillary carcinomas of the breast

Papillary Carcinomas of the Breast are a rare and distinct type of breast cancer characterized by the presence of finger-like projections, or papillae, within the tumor. These tumors can occur in both men and women, though they are more common in women, particularly those who are post-menopausal. Papillary carcinomas can be further classified into several subtypes, including invasive papillary carcinoma and intraductal papillary carcinoma, each with its own characteristics and implications for treatment and prognosis.

Classification

Papillary carcinomas of the breast are classified based on their growth patterns and whether they have spread beyond the ducts where they originated. The main types include:

• Intraductal Papillary Carcinoma: This non-invasive type remains within the ducts of the breast and is considered a form of ductal carcinoma in situ (DCIS). It is less likely to spread and generally has a favorable prognosis.
• Invasive Papillary Carcinoma: This type has spread beyond the ducts into the surrounding breast tissue. It is less common than the intraductal variety but requires more aggressive treatment.
• Encapsulated Papillary Carcinoma: A variant of invasive papillary carcinoma, encapsulated papillary carcinoma is encased in a fibrous capsule, which may limit its ability to spread.
• Solid Papillary Carcinoma: This subtype is characterized by solid masses of cells rather than the hollow, finger-like projections seen in other types. It can be either in situ or invasive.

Symptoms

Symptoms of papillary carcinomas can vary but may include:

• A lump in the breast that feels different from surrounding tissue
• Nipple discharge, which may be bloody
• Changes in the appearance of the nipple or breast skin, such as dimpling

Diagnosis

Diagnosis of papillary carcinomas involves a combination of physical examinations, imaging tests such as mammography and ultrasound, and biopsy procedures to obtain tissue samples for microscopic examination. Magnetic resonance imaging (MRI) may also be used in some cases to provide more detailed images of the breast.

Treatment

Treatment for papillary carcinomas depends on the type, size, and stage of the tumor, as well as the patient's overall health and preferences. Options may include:

• Surgery: Including lumpectomy (removal of the tumor and a small margin of surrounding tissue) or mastectomy (removal of one or both breasts).
• Radiation Therapy: Often used after surgery to destroy any remaining cancer cells in the breast.
• Hormone Therapy: For tumors that are hormone receptor-positive, medications that block hormones may be used to prevent cancer growth.
• Chemotherapy: May be recommended in cases where the cancer is more aggressive or has spread beyond the breast.

Prognosis

The prognosis for papillary carcinomas of the breast varies depending on the subtype and stage of the cancer at diagnosis. In general, the prognosis is favorable, especially for non-invasive and encapsulated forms, which are less likely to spread. However, regular follow-up is essential to monitor for recurrence or the development of new cancers.

Prevention and Screening

There are no specific measures to prevent papillary carcinomas of the breast, but regular breast cancer screening is recommended to detect cancer early when it is most treatable. This includes mammograms and, for those at high risk, possibly MRI or ultrasound.

NIH genetic and rare disease info

• NIH info on Papillary carcinomas of the breast

Papillary carcinomas of the breast is a rare disease.