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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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Turashvili G. Nonneoplastic and neoplastic sclerosing lesions of the breast. Histopathology 2024. [PMID: 38923027 DOI: 10.1111/his.15252] [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: 06/28/2024]
Abstract
Sclerosing lesions of the breast encompass a spectrum of benign and malignant entities and often pose a diagnostic challenge. Awareness of key morphologic features and pitfalls in the assessment of morphology and immunophenotype is essential to avoid over- or underdiagnosis and ensure optimal clinical management. This review summarizes nonneoplastic sclerosing lesions such as radial scar/complex sclerosing lesion, sclerosing adenosis, sclerosing intraductal papilloma, sclerosing variants of ductal adenoma and nipple adenoma, and fibroadenoma with extensive sclerosis, including their clinical presentation, characteristic morphology, differential diagnostic considerations, appropriate immunohistochemical work-up, when needed, and the clinical significance. In addition, atypical or neoplastic entities (such as atypical ductal hyperplasia, ductal carcinoma in situ, low-grade adenosquamous carcinoma, and fibromatosis-like metaplastic carcinoma) that can involve these sclerosing lesions are also briefly discussed.
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Affiliation(s)
- Gulisa Turashvili
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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3
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Gurdal N, Yildirim BA, Gursel OK, Ozkurt S, Ibis K, Gultekin M, Tepetam H, Gul SK, Guzeloz Z, Oksuz DC, Cetin IA, Yalcin B, Duzova M, Kanyilmaz G, Yavas G, Ozsaran Z. Oncological outcomes for encapsulated papillary carcinoma of the breast: Multicentric study of Turkish Society for Radiation Oncology breast cancer study group (TROD 06-014 study). Asia Pac J Clin Oncol 2023; 19:e273-e282. [PMID: 36464924 DOI: 10.1111/ajco.13893] [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: 08/24/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Encapsulated papillary carcinoma (EPC) is a rare malignant papillary breast cancer accounting for approximately .5%-2% of all breast tumors. The aim of this multicenter study was to evaluate clinicopathologic features of EPC in addition to oncological outcomes and radiotherapy (RT) details. METHODS From 10 different academic hospitals in Turkey, we obtained pathology reports of 80 patients with histologically confirmed EPC between 2005 and 2022. Demographic, diagnostic, and treatment data were collected from medical records, retrospectively. Local failure, distant progression, toxicity-adverse effects, overall survival (OS), and disease-free survival were evaluated, and survival analyzes were performed using the Kaplan-Meier method. RESULTS Eighty patients with the diagnosis of misspelled sorry (ECP) were retrospectively evaluated. The median age of the patients was 63 (range, 35-85). After a median follow-up of 48 (range; 6-206) months, local recurrence was observed in three patients (4%). Local recurrence was less common in the patients who received whole breast RT with a tumour bed boost (p = .025). There were not any distant metastasis or disease-related death. RT was applied to 61% of the cases, and no treatment-related grade 3 or higher toxicity was reported in any of the patients. Five year OS, cancer-specific survival (CSS), and were observed as 85%, 100%, and 96%, respectively. CONCLUSIONS ECP is a rare, slow-progressing breast carcinoma associated with good prognosis, it is a disease of elderly patient, and usually occurs in postmenopausal women. It responds extremely well to optimal local treatments and appropriate adjuvant treatments on a patient basis, and has excellent OS and CSS ratios.
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Affiliation(s)
- Necla Gurdal
- Department of Radiation Oncology, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Berna Akkus Yildirim
- Department of Radiation Oncology, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Ozge Kandemir Gursel
- Department of Radiation Oncology, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Selnur Ozkurt
- Department of Radiation Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kamuran Ibis
- Department of Radiation Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Melis Gultekin
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Huseyin Tepetam
- Department of Radiation Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Sule Karabulut Gul
- Department of Radiation Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Zeliha Guzeloz
- Department of Radiation Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Didem Colpan Oksuz
- Department of Radiation Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ilknur Alsan Cetin
- Department of Radiation Oncology, Marmara University, Pendik Education and Research Hospital, Istanbul, Turkey
| | - Berrin Yalcin
- Department of Radiation Oncology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Mursel Duzova
- Department of Radiation Oncology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Gul Kanyilmaz
- Department of Radiation Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Guler Yavas
- Department of Radiation Oncology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Zeynep Ozsaran
- Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir, Turkey
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Xu L, Mao Q, Liu Q, Gao Y, Luo L, Guo C, Qu W, Yan N, Cao Y. Encapsulated papillary carcinoma of the breast: A single institution experience. Oncol Lett 2023; 26:459. [PMID: 37736553 PMCID: PMC10509775 DOI: 10.3892/ol.2023.14046] [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: 12/09/2022] [Accepted: 06/20/2023] [Indexed: 09/23/2023] Open
Abstract
Encapsulated papillary carcinoma (EPC) is a relatively rare form of breast cancer. To date, no evidence-based guidelines for the treatment of EPC have been established. Between January 2015 and December 2021, patients with histologically confirmed EPC of the breast were recorded in a database by The Third Hospital of Nanchang City (Nanchang, China). A total of 46 patients with EPC were retrieved from the database. Age at diagnosis ranged from 41-88 years (median age, 62 years). A total of 21 of these patients had pure EPC, 6 patients had EPC associated with ductal carcinoma in situ and 19 patients had EPC associated with invasive carcinoma. The majority of EPC cases were low nuclear grade, hormone receptor-positive and human epidermal growth factor receptor-2-negative. Additionally, myoepithelial cells were always absent in the papillae of the EPC. All patients underwent lumpectomy or mastectomy with sentinel lymph node biopsy, and almost all of the patients received adjuvant hormonal therapy. Adjuvant chemotherapy was only suggested to 4 patients who were diagnosed with axillary lymph node involvement. Subsequently, the clinicopathological features of non-invasive EPC were compared with invasive EPC. The results indicated that larger tumor sizes and axillary lymph node metastases were more common in invasive tumors. During the follow-up, only 2 patients with invasive EPC experienced recurrence or metastasis. In conclusion, a substantial proportion of invasive EPC cases display aggressive characteristics and metastatic potential, despite it being considered a subtype of carcinoma in situ with excellent prognosis, and local surgical resection is the initial method of treatment. Therefore, adjuvant endocrine therapy, radiotherapy and chemotherapy should be considered in select patients, especially in those diagnosed with invasive EPC tumors.
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Affiliation(s)
- Liang Xu
- Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China
| | - Qixin Mao
- Department of Breast Disease, Henan Breast Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450002, P.R. China
| | - Qiuming Liu
- Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China
| | - Yufeng Gao
- Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China
| | - Lihua Luo
- Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China
| | - Chungen Guo
- Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China
| | - Wei Qu
- Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China
| | - Ningning Yan
- Department of Medical Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450002, P.R. China
| | - Yali Cao
- Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China
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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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Niver HE, Strom P. Axillary chest wall solid-papillary carcinoma: A case report on presentation and management. Rare Tumors 2023; 15:20363613231155957. [PMID: 36761373 PMCID: PMC9905025 DOI: 10.1177/20363613231155957] [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: 10/06/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023] Open
Abstract
Papillary breast carcinomas comprise <1% of all breast cancers. They are notorious among surgical pathologists for posing diagnostic difficulty, especially with small sample sizes, such as a core-needle biopsy and carry potential for overtreatment. Solid-papillary carcinoma is a subtype of papillary breast carcinomas that affects elderly females and generally has a favorable diagnosis in its in-situ form. This report focuses on the unique and clinically aggressive presentation and treatment of invasive solid-papillary carcinoma that was discovered along the axillary chest wall after an ipsilateral mastectomy for multifocal ductal carcinoma in situ.
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Affiliation(s)
- Harper E. Niver
- Harper E Niver, Northeast Georgia Medical Center, 743 Spring Street, Gainesville, GA 30501, USA.
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Yin Z, Zhao Y, Zhou W, You C, Bai Y, You B, Lu D, Liao S, Zheng L, Sun Y, Wu Y. A 20-Gene Signature Predicting Survival in Patients with Clear Cell Renal Cell Carcinoma Based on Basement Membrane. JOURNAL OF ONCOLOGY 2023; 2023:1302278. [PMID: 37089260 PMCID: PMC10118896 DOI: 10.1155/2023/1302278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/07/2022] [Indexed: 04/25/2023]
Abstract
Objectives The most common subtype of renal cell carcinoma, clear cell renal cell carcinoma (ccRCC), has a high heterogeneity and aggressive nature. The basement membrane (BM) is known to play a vital role in tumor metastasis. BM-related genes remain untested in ccRCC, however, in terms of their prognostic significance. Methods BM-related genes were gleaned from the most recent cutting-edge research. The RNA-seq and clinical data of the ccRCC were obtained from TCGA and GEO databases, respectively. The multigene signature was constructed using the univariate Cox regression and the LASSO regression algorithm. Then, clinical features and prognostic signatures were combined to form a nomogram to predict individual survival probabilities. Using functional enrichment analysis and immune-correlation analysis, we investigated potential enrichment pathways and immunological characteristics associated with BM-related-gene signature. Results In this study, we built a model of 20 BM-related genes and classified them as high-risk or low-risk, with each having its anticipated risk profile. Patients in the high-risk group showed significantly reduced OS compared with patients in the low-risk group in the TCGA cohort, as was confirmed by the testing dataset. Functional analysis showed that the BM-based model was linked to cell-substrate adhesion and tumor-related signaling pathways. Comparative analysis of immune cell infiltration degrees and immune checkpoints reveals a central role for BM-related genes in controlling the interplay between the immune interaction and the tumor microenvironment of ccRCC. Conclusions We combined clinical characteristics known to predict the prognosis of ccRCC patients to create a gene signature associated with BM. Our findings may also be useful for forecasting how well immunotherapies would work against ccRCC. Targeting BM may be a therapeutic alternative for ccRCC, but the underlying mechanism still needs further exploration.
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Affiliation(s)
- Zhenjie Yin
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Yu Zhao
- Department of Medical and Radiation Oncology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Weiwen Zhou
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Chengcheng You
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, Hubei 443002, China
| | - Yuanyuan Bai
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Bingyong You
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Dongming Lu
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Shangfan Liao
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Luoping Zheng
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Yingming Sun
- Department of Medical and Radiation Oncology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
| | - Yongyang Wu
- Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, Fujian 365001, China
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Hoda RS, Brogi E, Wen HY. Quality Issues in Diagnostic Immunohistochemistry in Breast Pathology. Pathobiology 2022; 89:324-333. [PMID: 35443240 DOI: 10.1159/000522538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/31/2022] [Indexed: 11/19/2022] Open
Abstract
Immunohistochemistry techniques have been incorporated into surgical pathology for nearly a half-century and have since become intimately intertwined with its practice. In the realm of breast pathology, immunohistochemistry serves several purposes, including providing crucial prognostic and predictive data. Among its other applications, assessment of stromal invasion and establishment of mammary origin are crucial from a diagnostic standpoint. In these regards, sole reliance on immunohistochemistry may lead to misdiagnosis. In this review, we highlight pitfalls of immunohistochemistry commonly encountered in the practice of breast pathology and emphasize the importance of careful histopathological evaluation.
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Affiliation(s)
- Raza S Hoda
- Robert J Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hannah Y Wen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA,
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