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Wang S, Zhang Q, Zhang T, Mao X. Invasive papillary carcinoma of the breast: A case report. Oncol Lett 2024; 28:300. [PMID: 38765791 PMCID: PMC11099954 DOI: 10.3892/ol.2024.14433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Invasive papillary carcinoma (IPC) of the breast is a rare form of cancer. The current report documents a case of IPC characterized by a large tumor size and skin involvement. Surgical exploration revealed no evidence of axillary lymph node metastasis in breast cancer. Due to financial constraints, the patient opted solely for anastrozole endocrine therapy at a dosage of 1 mg/day for a period of 5 years post-surgery, foregoing other treatments such as radiotherapy and chemotherapy. Since discharge, 2.5 years have passed, during which the patient has been followed up via phone every 3 months, showing a good prognosis. A literature review indicated that IPC is prevalent amongst the elderly population and can be misdiagnosed due to its morphological, cytomorphological and immunophenotypic overlap with other types of papillary neoplasms. This tumor exhibits a more favorable prognosis compared with IDC, primarily attributed to its advantageous gene and molecular expression patterns, coupled with its decreased invasiveness. Despite limited evidence-based research on the treatment of IPC, the present case report, albeit with limitations, underscores the importance of avoiding over-treatment and suggests the feasibility of combining surgery with endocrine therapy for IPC.
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Affiliation(s)
- Shijing Wang
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Qingfu Zhang
- Department of Pathology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Tangbo Zhang
- Department of Pathology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Xiaoyun Mao
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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2
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Rakha EA, Adebayo LA, Abbas A, Hodi Z, Lee AHS, Ellis IO. Second opinion (external specialist referral) practice of breast pathology: the Nottingham experience. Histopathology 2023; 83:394-405. [PMID: 37356966 DOI: 10.1111/his.14993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/27/2023]
Abstract
AIMS Breast pathology is a challenging field, and discrepancies in diagnoses exist and can affect patient management. This study aims to review a breast referral practice and assess the pattern and frequency of breast lesions sent for an external expert review and evaluate potential impacts on patients' care. METHODS AND RESULTS Seven hundred and forty cases that were referred to Nottingham City Hospital for a second opinion between 2019 and 2022 which have slides and reports were retrieved and reviewed. Reasons for referral, initial diagnosis, proffered specialist opinion and any discrepancy or potential impacts of management were assessed. The most frequent entities were papillary lesions (19%), fibroepithelial lesions (17%), invasive carcinomas that were sent for confirmation of the invasive diagnosis or subtyping of the invasive tumour (17%), intraductal epithelial proliferation with atypia (9%) and spindle cell lesions (8%). Other entities included biphasic tumours such as adenomyoepithelioma, as well as vascular and nipple lesions. Few cases were sent for prognostic classification or comments on the management, and in occasional cases no initial diagnosis was offered. After reviewing the cases by the expert pathologists, the initial diagnosis was confirmed or one of the suggested diagnoses was preferred in 79% of cases, including 129 cases (17%) in which the opinion resulted minor changes in the management. Significant changes in the classification of lesions were made in 132 cases (18%) which resulted in significant change in the patient management recommendation. In 14 cases (2%) a final classification was not possible, and further specialist opinion was obtained. Comments on the differential diagnosis and advice on further patient management were provided in most cases. CONCLUSIONS This study demonstrates the value of external referral of challenging, rare and difficult to classify breast lesions. It also highlights the most common breast lesions that are likely to be challenging, and specialist opinion can refine their classification to improve patient care.
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Affiliation(s)
- Emad A Rakha
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
- Academic Unit for Translational Medical Sciences, School of Medicine, The University of Nottingham, Nottingham, UK
- Pathology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Luqman Adedotun Adebayo
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
| | - Areeg Abbas
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
| | - Zsolt Hodi
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
| | - Andrew H S Lee
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
| | - Ian O Ellis
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
- Academic Unit for Translational Medical Sciences, School of Medicine, The University of Nottingham, Nottingham, UK
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3
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Ghannam SF, Rutland CS, Allegrucci C, Mongan NP, Rakha E. Encapsulated papillary carcinoma of the breast: does it have a native basement membrane? Histopathology 2023; 83:376-393. [PMID: 37232543 DOI: 10.1111/his.14939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/08/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Encapsulated papillary carcinoma (EPC) is surrounded by a thick fibrous capsule-like structure, which is interpreted as a thickened basement membrane (BM). This study aimed to describe the geometric characteristics of the EPC capsule and to refine whether it is an expansion of the BM or a stromal reactive process. MATERIAL AND METHODS In all, 100 cases were divided into four groups: EPC, ductal carcinoma in situ (DCIS), normal breast tissue and invasive tumours, with an additional encapsulated papillary thyroid carcinoma (EPTC) control group. Representative slides from each case were stained with picrosirius red (PSR) stain and examined using polarised microscopy. Images were analysed using ImageJ, CT-FIRE, and Curve align image analysis programmes. RESULTS Compared to the normal and DCIS BM, the EPC group showed a significant increase of collagen fibre width, straightness, and density, and a decrease of fibre length. The EPC capsule showed less alignment of fibres with a more perpendicular arrangement, and it was enriched with disorganised collagen type I (stromal collagen) fibres. Compared to other groups, the EPC capsule showed significant variation in the thickness, evenness, distribution of collagen fibres, and significant intracapsular heterogeneity. Compared to BM-like material in the invasive group, the EPC capsule showed a higher density of collagen fibres with longer, straighter, and more aligned fibres, but there was no difference in the distribution of both collagen types I and III. Conversely, compared to EPTC, there were no differences between both EPC and EPTC capsules except that the fibres in the EPC capsule were straighter. Although differences between normal ducts and lobules and DCIS BM collagen fibre density, straightness, orientation, and alignment were detected, both were significantly different from EPC capsule. CONCLUSION This study provided evidence that the EPC capsule is a reactive process rather than a thickened native BM characteristic of normal and in situ lesions, which provides further evidence that EPC is an indolent invasive carcinoma based on capsule characteristics.
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Affiliation(s)
- Suzan F Ghannam
- Division of Cancer and Stem Cells, School of Medicine, The University of Nottingham, Nottingham, UK
- Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
| | - Catrin S Rutland
- School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK
| | - Cinzia Allegrucci
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
- School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK
| | - Nigel P Mongan
- School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK
- Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA
| | - Emad Rakha
- Division of Cancer and Stem Cells, School of Medicine, The University of Nottingham, Nottingham, UK
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
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4
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Ma T, Semsarian CR, Barratt A, Parker L, Pathmanathan N, Nickel B, Bell KJL. Should low-risk DCIS lose the cancer label? An evidence review. Breast Cancer Res Treat 2023; 199:415-433. [PMID: 37074481 PMCID: PMC10175360 DOI: 10.1007/s10549-023-06934-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/30/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Population mammographic screening for breast cancer has led to large increases in the diagnosis and treatment of ductal carcinoma in situ (DCIS). Active surveillance has been proposed as a management strategy for low-risk DCIS to mitigate against potential overdiagnosis and overtreatment. However, clinicians and patients remain reluctant to choose active surveillance, even within a trial setting. Re-calibration of the diagnostic threshold for low-risk DCIS and/or use of a label that does not include the word 'cancer' might encourage the uptake of active surveillance and other conservative treatment options. We aimed to identify and collate relevant epidemiological evidence to inform further discussion on these ideas. METHODS We searched PubMed and EMBASE databases for low-risk DCIS studies in four categories: (1) natural history; (2) subclinical cancer found at autopsy; (3) diagnostic reproducibility (two or more pathologist interpretations at a single time point); and (4) diagnostic drift (two or more pathologist interpretations at different time points). Where we identified a pre-existing systematic review, the search was restricted to studies published after the inclusion period of the review. Two authors screened records, extracted data, and performed risk of bias assessment. We undertook a narrative synthesis of the included evidence within each category. RESULTS Natural History (n = 11): one systematic review and nine primary studies were included, but only five provided evidence on the prognosis of women with low-risk DCIS. These studies reported that women with low-risk DCIS had comparable outcomes whether or not they had surgery. The risk of invasive breast cancer in patients with low-risk DCIS ranged from 6.5% (7.5 years) to 10.8% (10 years). The risk of dying from breast cancer in patients with low-risk DCIS ranged from 1.2 to 2.2% (10 years). Subclinical cancer at autopsy (n = 1): one systematic review of 13 studies estimated the mean prevalence of subclinical in situ breast cancer to be 8.9%. Diagnostic reproducibility (n = 13): two systematic reviews and 11 primary studies found at most moderate agreement in differentiating low-grade DCIS from other diagnoses. Diagnostic drift: no studies found. CONCLUSION Epidemiological evidence supports consideration of relabelling and/or recalibrating diagnostic thresholds for low-risk DCIS. Such diagnostic changes would need agreement on the definition of low-risk DCIS and improved diagnostic reproducibility.
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Affiliation(s)
- Tara Ma
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Caitlin R Semsarian
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Alexandra Barratt
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Wiser Healthcare, Sydney, Australia
| | - Lisa Parker
- Sydney School of Pharmacy, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Department of Radiation Oncology, Royal North Shore Hospital, Sydney, Australia
| | - Nirmala Pathmanathan
- Western Sydney Local Health District, Sydney, Australia
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | - Brooke Nickel
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Katy J L Bell
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
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Calle C, Zhong E, Hanna MG, Ventura K, Friedlander MA, Morrow M, Cody H, Brogi E. Changes in the Diagnoses of Breast Core Needle Biopsies on Second Review at a Tertiary Care Center: Implications for Surgical Management. Am J Surg Pathol 2023; 47:172-182. [PMID: 36638314 PMCID: PMC10464622 DOI: 10.1097/pas.0000000000002002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Core needle biopsy (CNB) of breast lesions is routine for diagnosis and treatment planning. Despite refinement of diagnostic criteria, the diagnosis of breast lesions on CNB can be challenging. At many centers, including ours, confirmation of diagnoses rendered in other laboratories is required before treatment planning. We identified CNBs first diagnosed elsewhere that were reviewed in our department over the course of 1 year because the patients sought care at our center and in which a change in diagnosis had been recorded. The outside and in-house CNB diagnoses were then classified based on Breast WHO Fifth Edition diagnostic categories. The impact of the change in diagnosis was estimated based on the subsequent surgical management. Findings in follow-up surgical excisions (EXCs) were used for validation. In 2018, 4950 outside cases with CNB were reviewed at our center. A total of 403 CNBs diagnoses were discrepant. Of these, 147 had a change in the WHO diagnostic category: 80 (54%) CNBs had a more severe diagnosis and 44 (30%) a less severe diagnosis. In 23 (16%) CNBs, the change of diagnostic category had no impact on management. Intraductal proliferations (n=54), microinvasive carcinoma (n=18), and papillary lesions (n=35) were the most disputed diagnoses. The in-house CNB diagnosis was confirmed in most cases with available excisions. Following CNB reclassification, 22/147 (15%) lesions were not excised. A change affecting the surgical management at our center occurred in 2.5% of all CNBs. Our results support routine review of outside breast CNB as a clinically significant practice before definitive treatment.
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Affiliation(s)
- Catarina Calle
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, 10065 USA
- Faculdade de Ciencias da Saude da Universidade da Beira Interior, Covilha, Portugal
| | - Elaine Zhong
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, 10065 USA
| | - Matthew G. Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, 10065 USA
| | - Katia Ventura
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, 10065 USA
| | - Maria A. Friedlander
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, 10065 USA
| | - Monica Morrow
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Hiram Cody
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, 10065 USA
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Joneja U, Palazzo J. The Spectrum of Mucinous Lesions of the Breast. Arch Pathol Lab Med 2023; 147:19-29. [PMID: 36577093 DOI: 10.5858/arpa.2022-0054-ra] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 12/29/2022]
Abstract
CONTEXT.— Mucinous lesions of the breast encompass many entities ranging from benign to malignant and nonneoplastic to neoplastic. Lesions discussed under this category are mucocele-like lesion, mucinous carcinoma, mucinous micropapillary carcinoma, solid papillary carcinoma, mucinous cystadenocarcinoma, mucoepidermoid carcinoma, invasive lobular carcinoma with extracellular mucin, mucinous ductal carcinoma in situ, and metastasis. OBJECTIVE.— To review clinical, pathologic, and molecular features of mucinous lesions of the breast, their differential diagnoses, and challenging features on core needle biopsies. DATA SOURCES.— The existing scientific and clinical literature as of December 2021. CONCLUSIONS.— The category of mucinous lesions of the breast is vast and the differential diagnosis can be challenging, especially on core needle biopsies. In all cases, clinical, radiologic, and pathologic correlation is necessary to reach a comprehensive diagnosis. Given that the prognosis and management of each entity is different, being aware of these entities and their nuances is critical for a pathologist to guide accurate management.
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Affiliation(s)
- Upasana Joneja
- From the Department of Pathology, Cooper University Hospital, Camden, New Jersey (Joneja)
| | - Juan Palazzo
- The Department of Pathology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (Palazzo)
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Liu C, Liu S, Zhao L, Zheng W, Wang K, Tian Y, Gui Z, Zhang L. Intraductal papillary carcinoma of breast with invasion: A nomogram and survival from the analysis of the SEER database. Cancer Med 2022; 12:1305-1318. [PMID: 35837839 PMCID: PMC9883418 DOI: 10.1002/cam4.5007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Intraductal papillary carcinoma (IPC) with invasion is a rare type of breast cancer. There have been few studies on its prognosis, and a nomogram that predicts the prognosis of the disease has not been described to date. METHODS Patients who were diagnosed with invasive IPC were screened from the Surveillance, Epidemiology, and End Results (SEER) database. The screened patients were randomly divided into a training cohort and a verification cohort at 7:3. A Cox proportional hazard regression model was performed to analyze the effects of different variables on the risk of death in invasive IPC. A nomogram was constructed to quantify the possibility of death. The concordance index (C-index), calibration plots, receiver operating characteristic (ROC) curves, and decision curves analysis (DCA) were used to verify the proposed model. RESULTS We included a total of 803 patients diagnosed with invasive IPC, including 563 patients in the training cohort and 240 patients in the validation cohort. The median follow-up times in the training cohort and validation cohort were 63 months (range, 2-155 months) and 61 months (range, 1-154 months), respectively. For all patients, the probability of death with invasive IPC was 1.4% within 5 years and 5.4% within 10 years. In multivariate analysis, sex, race, tumor size, lymph node status, type of treatment, and chemotherapy were related to the prognosis of invasive IPC. We constructed a nomogram to predict the possibility of death in patients with invasive IPC. CONCLUSION Patients with invasive IPC had a high survival rate. The proven nomogram was helpful to both patients and clinical decision makers.
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Affiliation(s)
- Chenguang Liu
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Shiyang Liu
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Lu Zhao
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Weihong Zheng
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Kun Wang
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Yao Tian
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Zhengwei Gui
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Lin Zhang
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
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Patel A, Hoda RS, Hoda SA. Papillary Breast Tumors: Continuing Controversies and Commentary on WHO's 2019 Criteria and Classification. Int J Surg Pathol 2021; 30:124-137. [PMID: 34351218 DOI: 10.1177/10668969211035843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The category of papillary breast tumors includes a limited number of entities. Nonetheless, this relatively uncommon group of tumors seems to instigate a disproportionate degree of diagnostic disquiet. As a group, papillary breast tumors suffer from a relatively high rate of discordant interpretation. The latter is due to the inherent complexity of the lesions compounded by conflicting criteria as well as simmering controversies. For instance, "encapsulated" papillary carcinoma remains contentious with regards to whether these are noninvasive or not, and the assessment of the extent of the invasive versus noninvasive components in many solid papillary carcinomas can be problematic. The latest classification system of breast tumors enunciated by the World Health Organization (WHO), that is, Breast Tumors, which appeared in 2019, mainly sought to incorporate advances in basic and clinical sciences into diagnostic criteria for the entire spectrum of breast neoplasms-including papillary ones. The latter category of tumors is discussed at some length in Breast Tumors; however, it still appears to suffer from some lack of clarity in its subclassification. It is our intent in this communication to provide an overview of the controversies around papillary breast tumors, and offer comments on its coverage in Breast Tumors-so that any tangible or perceived ambiguities therein could be addressed in its next edition.
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Affiliation(s)
- Ami Patel
- 12295Weill Cornell Medical College, New York, NY, USA
| | | | - Syed A Hoda
- 12295Weill Cornell Medical College, New York, NY, USA
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Li X, Febres-Aldana C, Zhang H, Zhang X, Uraizee I, Tang P. Updates on Lobular Neoplasms, Papillary, Adenomyoepithelial, and Fibroepithelial Lesions of the Breast. Arch Pathol Lab Med 2021; 146:930-939. [PMID: 34270716 DOI: 10.5858/arpa.2021-0091-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— This review article is a result of the breast pathology lectures given at the Sixth Chinese American Pathologists Association annual diagnostic pathology course in October 2020 (held virtually due to the coronavirus disease 2019). OBJECTIVE.— To update recent developments, in this review article, the authors wrote minireviews in the following 4 areas: lobular neoplasm, adenomyoepithelial lesions, papillary lesions, and fibroepithelial lesions. DATA SOURCES.— The sources include extensive literature review, personal research, and experience. CONCLUSIONS.— With the wide practice of screening mammography, these lesions are not uncommon in image-guided core biopsies and excisional specimens. Many recent developments have emerged in understanding these lesions. We aim to provide readers with concise updates for each of these lesions with a focus on recent updates in definitions, diagnostic criteria, management, and molecular profiles that are most relevant to the daily practice of pathology and patient management.
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Affiliation(s)
- Xiaoxian Li
- From the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (Li)
| | - Christopher Febres-Aldana
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Febres-Aldana, H. Zhang)
| | - Hong Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Febres-Aldana, H. Zhang)
| | - Xinmin Zhang
- Department of Pathology, Cooper University Health Care, Camden, New York (X. Zhang)
| | - Imran Uraizee
- The Department of Pathology and Laboratory Medicine, Loyola University, Maywood, Illinois (Uraizee, Tang)
| | - Ping Tang
- The Department of Pathology and Laboratory Medicine, Loyola University, Maywood, Illinois (Uraizee, Tang)
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10
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Morgan S, Dodington D, Wu JM, Turashvili G. Solid Papillary Carcinoma and Encapsulated Papillary Carcinoma of the Breast: Clinical-Pathologic Features and Basement Membrane Studies of 50 Cases. Pathobiology 2021; 88:359-373. [PMID: 34265775 DOI: 10.1159/000517189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/10/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Solid papillary carcinoma (SPC) and encapsulated papillary carcinoma (EPC) of the breast are usually considered in situ lesions due to favorable prognosis, despite the variable presence of myoepithelial cells. We aimed to describe clinical-pathologic features including basement membrane (BM) studies in these tumors. METHODS Patients diagnosed with SPC and EPC in 2000-2019 were retrospectively identified. Microscopic slides and clinical history were reviewed. Immunohistochemical stains for BM and myoepithelial markers were performed. RESULTS Of 23 SPCs and 27 EPCs, there were 5/23 (21.7%) pure SPCs and 9/27 (33.3%) pure EPCs, while 4/23 (17.4%) and 12/27 (44.5%) were associated with ductal carcinoma in situ (DCIS), and 6/23 (26.1%) and 6/27 (22.2%) with invasive carcinoma, respectively; 8/23 (34.8%) SPCs were considered invasive. The median tumor size was 1.7 cm (range 0.1-16). All tumors were positive for hormone receptors and negative for HER2. Myoepithelial cells were absent in 20 tumors (40%) and focally present in 30 (60%). Collagen IV and laminin were negative in most invasive lesions, but they were expressed in 21/21 (100%) and 18/21 (85.7%) of EPCs without invasion, and 16/17 (94.1%) and 10/17 (58.8%) SPCs, including invasive SPCs, respectively. Lymph node involvement was identified in 3/26 (11.5%) patients, including micrometastasis in 1 EPC associated with DCIS, macrometastasis in 1 EPC associated with invasive carcinoma, and isolated tumor cells in 1 invasive SPC. Of 31 patients with outcome data (median follow-up 35 months, range 1-85), 2 (6.5%; 1 SPC, 1 EPC) developed local recurrence, both associated with invasive carcinoma. No distant recurrences or deaths were observed. CONCLUSIONS Our study confirms favorable prognosis of SPCs and EPCs, with 2 local recurrences occurring in the presence of invasion. SPCs are more commonly associated with invasive carcinoma or considered invasive compared to EPCs (60.9 vs. 22.2%). The presence of BM material and lack of lymph node involvement in most cases indicates that the majority of these tumors may represent in situ lesions; however, some may behave as low-grade invasive malignancy with metastatic potential even in the absence of conventional invasion.
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Affiliation(s)
- Sarah Morgan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - David Dodington
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jessie M Wu
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Gulisa Turashvili
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
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11
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Papillary neoplasms of the breast-reviewing the spectrum. Mod Pathol 2021; 34:1044-1061. [PMID: 33462367 DOI: 10.1038/s41379-020-00732-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/15/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
Papillary neoplasms of the breast encompass a wide range of tumor types ranging from the benign intraductal papilloma to in situ and invasive papillary carcinomas. In this review, we considered each tumor entity listed under the Papillary Neoplasms category in the latest WHO Classification of Breast Tumors (5th edition), namely intraductal papilloma, papillary ductal carcinoma in situ, encapsulated papillary carcinoma, solid-papillary carcinoma, and invasive papillary carcinoma. We examined their pathological features, current issues pertaining to diagnosis and prognostication, as well as the latest molecular findings. We also briefly addressed adenomyoepithelioma and the newly included tall cell carcinoma with reversed polarity, highlighting areas where they overlap with papillary neoplasms.
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12
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Zhang X, Wu H, Wang Z, Zhou Y, Mao F, Lin Y, Shen S, Liang Z, Sun Q. Tall cell carcinoma of the breast with reverse polarity: case report with gene sequencing and literature review. Gland Surg 2021; 10:837-843. [PMID: 33708566 DOI: 10.21037/gs-20-695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Tall cell carcinoma of the breast with reverse polarity (TCCRP), described firstly and also known as tall cell variant of papillary breast carcinoma (TCVPBC), is a rare type of breast cancer that mimics papillary thyroid carcinoma (PTC) histopathologically. As the incidence of this type of tumor is very low, awareness of it is crucial to ensuring that unnecessary clinical investigations are avoided. The present study examined a 45-year-old woman in China who was diagnosed with TCCRP. This paper outlines her demographic and clinicopathologic data, and her follow-up and immunohistochemical examination results. Furthermore, this study used the next-generation sequencing (NGS) technique to identify concurrent isocitrate dehydrogenase 2 (IDH2) and phosphatidylinositol 3-kinase catalytic alpha (PIK3CA) hotspot mutations. Notably, the novel results of the study showed that the IDH2 R120 (rather than the IDH2 R172) mutation may also be present in this disease. Additionally, a comprehensive literature review was conducted to elucidate some of the significant clinical and pathological features of this type of disease. This information may provide important insights that can be used in diagnosis and treatment. It is essential both for physicians and pathologists to recognize the existence of TCCRP, with its own specific clinical and pathological characteristics. Further research using molecular biology techniques should be conducted in the future to characterize this unique entity.
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Affiliation(s)
- Xiaohui Zhang
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Huanwen Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Zhe Wang
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China.,Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Yidong Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Feng Mao
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Yan Lin
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Songjie Shen
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
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13
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Bonnet SE, Carter GJ, Berg WA. Encapsulated Papillary Carcinoma of the Breast: Imaging Features with Histopathologic Correlation. JOURNAL OF BREAST IMAGING 2020; 2:590-597. [PMID: 38424859 DOI: 10.1093/jbi/wbaa068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Indexed: 03/02/2024]
Abstract
Encapsulated papillary carcinoma (EPC) is a rare, clinically indolent breast malignancy most common in postmenopausal women. Absence of myoepithelial cells at the periphery is a characteristic feature. Mammographically, EPC typically presents as a mostly circumscribed, noncalcified, dense mass that can have focally indistinct margins when there is associated frank invasive carcinoma. Ultrasound shows a circumscribed solid or complex cystic and solid mass, and occasional hemorrhage in the cystic component may produce a fluid-debris level; the solid components typically show intense washout enhancement on MRI. Color Doppler may demonstrate a prominent vascular pedicle and blood flow within solid papillary fronds. Encapsulated papillary carcinoma can exist in pure form; however, EPC is often associated with conventional ductal carcinoma in-situ and/or invasive ductal carcinoma, no special type. Adjacent in-situ and invasive disease may be only focally present at the periphery of EPC and potentially unsampled at core-needle biopsy. In order to facilitate diagnosis, the mass wall should be included on core-needle biopsy, which will show absence of myoepithelial markers. Staging and prognosis are determined by any associated frankly invasive component, with usually excellent long-term survival and rare distant metastases.
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Affiliation(s)
- Sarah E Bonnet
- Magee-Womens Hospital of UPMC, Department of Radiology, Pittsburgh, PA
| | - Gloria J Carter
- Magee-Womens Hospital of UPMC, Department of Pathology, Pittsburgh, PA
| | - Wendie A Berg
- Magee-Womens Hospital of UPMC, Department of Radiology, Pittsburgh, PA
- University of Pittsburgh School of Medicine, Department of Radiology, Pittsburgh, PA
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14
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Lin X, Matsumoto Y, Nakakimura T, Ono K, Umeoka S, Torii M, Yoshibayashi H, Toi M. Invasive solid papillary carcinoma with neuroendocrine differentiation of the breast: a case report and literature review. Surg Case Rep 2020; 6:143. [PMID: 32562013 PMCID: PMC7305294 DOI: 10.1186/s40792-020-00905-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 06/10/2020] [Indexed: 11/22/2022] Open
Abstract
Background Solid papillary carcinoma (SPC) of the breast is a rare breast cancer that accounts for less than 1% of all breast cancers. The optimal clinical management of SPC remains controversial. Here, we report a case of invasive SPC with neuroendocrine differentiation in addition to review of the current literature. Case presentation A premenopausal 46-year-old female presented with a mass in her left breast that tended to increase in size over a 10-month period. Mammography and ultrasonography revealed a mass in the left upper-inner quadrant. The resulting images suggested a category 3 breast tumor according to the Breast Imaging Reporting and Data System (BI-RADS). A core needle biopsy (CNB) was performed, and the pathological findings showed a solid papillary pattern and atypical cells suggestive of noninvasive SPC. After a left partial mastectomy and sentinel lymph node biopsy (SLNB), the specimens were sent for histopathological analysis for further investigation. Postoperative pathological findings suggested invasive SPC. Whole-breast radiation therapy and adjuvant hormonal therapy were performed as postoperative treatments. Three years after surgery, multiple lung metastases were detected, and the patient was treated with a gonadotropin-releasing hormone agonist and an aromatase inhibitor. Five months later, multiple liver metastases and bone metastases appeared, and oral 5-fluorouracil was chosen for the subsequent treatment. The patient has been treated for 5 years to date, and she is continuing to take oral 5-fluorouracil and is alive without any further disease progression. Conclusions We report a rare case of premenopausal invasive SPC with multiple metastases. Further study is needed to clarify the molecular characteristics and clinical behaviors of SPC and to explore the optimal treatment strategy.
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Affiliation(s)
- Xue Lin
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan. .,Department of Breast Surgery, Kyoto University Hospital, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Yoshiaki Matsumoto
- Department of Breast Surgery, Kyoto University Hospital, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tomomi Nakakimura
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Kazuo Ono
- Department of Diagnostic Pathology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Shigeaki Umeoka
- Department of Diagnostic Radiology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Masae Torii
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Hiroshi Yoshibayashi
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University Hospital, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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15
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Abdelwahed A, Ahmed M. Rare epithelial breast cancer: surgery and adjuvant therapy. Transl Cancer Res 2019; 8:S479-S492. [PMID: 35117126 PMCID: PMC8797705 DOI: 10.21037/tcr.2019.05.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/10/2019] [Indexed: 01/30/2023]
Abstract
Breast cancer is a heterogenous disease, exhibiting a wide range of morphological phenotypes shaping its prognosis and clinical course. However, optimal management of rarer breast cancer subtypes is often undefined and controversial in literature due to the lack of large studies and randomised trials. This review aims to discuss the treatment of 13 rare epithelial subtypes, focussing on surgery and adjuvant therapies.
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Affiliation(s)
| | - Muneer Ahmed
- King's College London, Division of Cancer, Research Oncology, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
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16
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Alsadoun N, MacGrogan G, Truntzer C, Lacroix-Triki M, Bedgedjian I, Koeb MH, El Alam E, Medioni D, Parent M, Wuithier P, Robert I, Boidot R, Arnould L. Solid papillary carcinoma with reverse polarity of the breast harbors specific morphologic, immunohistochemical and molecular profile in comparison with other benign or malignant papillary lesions of the breast: a comparative study of 9 additional cases. Mod Pathol 2018; 31:1367-1380. [PMID: 29785016 DOI: 10.1038/s41379-018-0047-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 02/03/2018] [Accepted: 02/04/2018] [Indexed: 12/26/2022]
Abstract
Solid papillary carcinoma with reverse polarity is a rare breast cancer of favorable prognosis that can be difficult to diagnose. We report here nine additional cases of this tumor, and we describe its morphologic, immunohistochemical and molecular profile in comparison to other types of papillary and micropapillary lesions of the breast that are intraductal papilloma with usual ductal hyperplasia, encapsulated papillary carcinoma, solid papillary carcinoma and invasive micropapillary carcinoma. We studied nine cases of this special papillary tumor and six of each other types mentioned above. We found that solid papillary carcinoma with reverse polarity harbor specific morphologic features as cuboid or tall cells with abundant eosinophilic cytoplasms located at the basal pole giving the impression of reverse nuclear polarity. Nuclei were sometimes grooved. Immunohistochemistry demonstrated the lack of myoepithelial cells, as in encapsulated papillary carcinoma and solid papillary carcinoma, questioning their invasive nature. Seven of nine solid papillary carcinoma with reverse polarity showed a low Ki67 proliferative index (Ki67 <5%). They showed expression of CK5/6 as in intraductal papilloma with usual ductal hyperplasia. They showed expression of calretinin and a low or lack of hormonal receptor (HR) expression that were not observed in other breast tumors studied. By whole-exome analysis, seven of nine solid papillary carcinomas with reverse polarity (78%) harbored a hotspot mutation in IDH2 (R172) that was totally absent in other groups. Six of nine tumors (67%) also harbored PRUNE2 mutation, including the two IDH2 wild-type cases. We also demonstrated for the first time in this breast tumor, immunostaining with a specific antibody IDH1/2 mutant R132/R172 (7/9) that can highlight IDH2 mutation. Moreover, transcriptomic analysis showed that proteoglycan pathway was significantly enriched. Our findings support the fact that solid papillary carcinoma with reverse polarity is a singular breast neoplasm that can be distinguished from other papillary breast tumors.
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Affiliation(s)
- Nadjla Alsadoun
- Département de Biologie et Pathologie des Tumeurs, Centre Georges-François Leclerc - Unicancer, 1 rue Professeur Marion, 21000, Dijon, France.
| | - Gaëtan MacGrogan
- Département de Biopathologie, Institut Bergonié, 229 cours de l'Argonne, 33076, Bordeaux, France
| | - Caroline Truntzer
- Département de Biologie et Pathologie des Tumeurs, Centre Georges-François Leclerc - Unicancer, 1 rue Professeur Marion, 21000, Dijon, France
| | - Magali Lacroix-Triki
- Département de Pathologie, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Isabelle Bedgedjian
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France
| | | | - Elsy El Alam
- Département de Pathologie, Institut Curie, Saint Cloud, 35 rue Dailly, 92210, Saint Cloud, France
| | - Dan Medioni
- Medipath Cannes-Antibes-Grasse, 80 allée des ormes, 06250, Mougins, France
| | - Michel Parent
- Pathologie Nord Unilabs, 60 boulevard Jean Baptiste Lebas, 59000, Lille, France
| | | | - Isabelle Robert
- Atalante Pathologie, 10 rue J-Louis Bertrand -BP11633, 35016, Rennes cedex, France
| | - Romain Boidot
- Département de Biologie et Pathologie des Tumeurs, Centre Georges-François Leclerc - Unicancer, 1 rue Professeur Marion, 21000, Dijon, France
| | - Laurent Arnould
- Département de Biologie et Pathologie des Tumeurs, Centre Georges-François Leclerc - Unicancer, 1 rue Professeur Marion, 21000, Dijon, France
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17
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Kővári B, Ormándi K, Simonka Z, Vörös A, Cserni G. Apocrine Encapsulated Papillary Carcinoma of the Breast: The First Reported Case with an Infiltrative Component. J Breast Cancer 2018; 21:227-230. [PMID: 29963120 PMCID: PMC6015972 DOI: 10.4048/jbc.2018.21.2.227] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/18/2018] [Indexed: 01/24/2023] Open
Abstract
Apocrine encapsulated papillary carcinoma (EPC) of the breast is a rare neoplasm, and only 10 cases have been reported in the literature to date. Although EPC by definition lacks a peripheral myoepithelial layer, all previously published apocrine EPC cases were clinically indolent and lacked a conventional invasive component. Herein, we report the 11th case of apocrine EPC, which had a conventional invasive carcinoma component and provides evidence of the malignant potential of this entity. We postulate that apocrine EPC is most likely a morphological variant of conventional EPC, with the same unpredictable malignant potential as non-apocrine cases.
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Affiliation(s)
- Bence Kővári
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Katalin Ormándi
- Department of Radiology, University of Szeged, Szeged, Hungary.,Affidea Diagnostics-Szeged, Szeged, Hungary
| | - Zsolt Simonka
- Department of Surgery, University of Szeged, Szeged, Hungary
| | - András Vörös
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Gábor Cserni
- Department of Pathology, University of Szeged, Szeged, Hungary.,Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
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18
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Rakha EA, Ellis IO. Diagnostic challenges in papillary lesions of the breast. Pathology 2018; 50:100-110. [DOI: 10.1016/j.pathol.2017.10.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 10/16/2017] [Indexed: 01/20/2023]
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19
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Katić V, Radojković D, Radovanović Z, Nagorni I, Jović A, Nedić M. Intracystic Papillary Carcinoma in a Male Breast: Thirty Years after Orchiectomy. ACTA FACULTATIS MEDICAE NAISSENSIS 2017. [DOI: 10.1515/afmnai-2017-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Papillary carcinoma of the breast is an extremely rare form of breast carcinoma in males. We report a case of an 83-year-old man who presented with a retroareolar palpable mass, associated with bloody nipple discharge. Cytological characteristics were rare clusters and papillary formations with enlarged hyperchromatic nuclei, surrounded by erythrocytes. Having in mind that a reliable cytological diagnosis of papillary carcinoma cannot be made and that all papillary lesions observed in cytological material should be excised for histological examination, breast conserving surgery (BCS) was performed.
Histologically, cystic ducts were lined with atypical papillary formations bridging the duct lumen, but with the absence of both myoepithelial cells and stromal invasion. Prolactin and testosterone serum levels were decreased. Immunohistochemical examination on actin, estrogen and progesteron receptors was negative.
The authors have pointed out that the patient had left orchiectomy, induced by tuberculous orchiepididymitis with scrotal fistula, performed thirty years before. Twelve months after breast conserving surgery, the patient is still alive.
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20
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Russ E. [Diagnostic challenges on breast needle core biopsies. Case 3: Encapsulated papillary carcinoma]. Ann Pathol 2017; 37:380-384. [PMID: 28935417 DOI: 10.1016/j.annpat.2017.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/08/2017] [Indexed: 11/18/2022]
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21
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[Diagnostic challenges on breast needle core biopsies. Case 4: Invasive papillary carcinoma]. Ann Pathol 2017; 37:385-388. [PMID: 28935413 DOI: 10.1016/j.annpat.2017.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/08/2017] [Indexed: 11/21/2022]
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22
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Mastoraki A, Papadoliopoulou M, Konstantiadou I, Mastoraki S, Danias N, Arkadopoulos N. Giant Intracystic Papillary Carcinoma of the Breast Report of a Case and Review of the Literature. J Gynecol Surg 2017. [DOI: 10.1089/gyn.2016.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Aikaterini Mastoraki
- 4th Department of Surgery, Athens University Medical School, ATTIKON University Hospital, Chaidari, Athens, Greece
| | - Maria Papadoliopoulou
- 4th Department of Surgery, Athens University Medical School, ATTIKON University Hospital, Chaidari, Athens, Greece
| | - Ioanna Konstantiadou
- 4th Department of Surgery, Athens University Medical School, ATTIKON University Hospital, Chaidari, Athens, Greece
| | - Sotiria Mastoraki
- 4th Department of Surgery, Athens University Medical School, ATTIKON University Hospital, Chaidari, Athens, Greece
| | - Nikolaos Danias
- 4th Department of Surgery, Athens University Medical School, ATTIKON University Hospital, Chaidari, Athens, Greece
| | - Nikolaos Arkadopoulos
- 4th Department of Surgery, Athens University Medical School, ATTIKON University Hospital, Chaidari, Athens, Greece
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23
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Abstract
Mass spectrometry imaging (MSI) has become a valuable tool in cancer research. Even more, due to its capability to directly link molecular changes with histology, it holds the prospect to revolutionize tissue-based diagnostics. In order to learn to walk before running, however, information obtained through classical histology should not be neglected but rather used to its full capacity and integrated with mass spectrometry data to lead to a superior molecular histology synthesis. In order to achieve this, pathomorphological analyses have to be integrated into MSI analyses right from the beginning to avoid errors and pitfalls of MSI application possibly leading to incorrect or imprecise study outcomes. Such errors can be caused by different sample or tissue inherent factors or through factors in sample preparation. Future studies should, therefore, aim for a comprehensive incorporation of histology and pathology characteristics to ensure the generation of high-quality data in MSI to exploit its full capacity in tissue-based basic and translational research.
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24
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Rakha EA, Ahmed MA, Aleskandarany MA, Hodi Z, Lee AHS, Pinder SE, Ellis IO. Diagnostic concordance of breast pathologists: lessons from the National Health Service Breast Screening Programme Pathology External Quality Assurance Scheme. Histopathology 2016; 70:632-642. [DOI: 10.1111/his.13117] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/02/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Emad A Rakha
- Department of Histopathology; Nottingham City Hospital; Nottingham B UK
| | - Mohamed A Ahmed
- Department of Histopathology; Nottingham City Hospital; Nottingham B UK
| | | | - Zsolt Hodi
- Department of Histopathology; Nottingham City Hospital; Nottingham B UK
| | - Andrew H S Lee
- Department of Histopathology; Nottingham City Hospital; Nottingham B UK
| | - Sarah E Pinder
- Cancer Studies; King's College London; Guy's Hospital; London UK
| | - Ian O Ellis
- Department of Histopathology; Nottingham City Hospital; Nottingham B UK
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