Article

Intracystic papillary carcinoma - A review of 917 cases

Department of Surgery, University of California at San Diego Medical Center, San Diego, California, USA.
Cancer (Impact Factor: 4.9). 09/2008; 113(5):916-20. DOI: 10.1002/cncr.23723
Source: PubMed

ABSTRACT Intracystic papillary carcinoma (IPC) is an uncommon breast neoplasm. To the authors' knowledge there are limited data regarding its epidemiology and only small studies focusing on outcomes. By using a large, population-based database, this study aimed to identify specific characteristics of patients with IPC, investigate its natural history, and determine its long-term prognosis.
The California Cancer Registry (CCR), a population-based registry, was reviewed from the years 1988 through 2005. The data were analyzed with regard to patient sex, age at presentation, tumor stage, and overall survival. Cumulative relative actuarial survival was determined using a Berkson-Gage life table method. The CCR classifies IPC as either in situ (CIS) or invasive, as determined by the local pathologist.
A total of 917 cases of IPC were identified. Approximately 47% of cases (n = 427) were CIS, whereas 53% of cases had invasion (n = 490). The majority of the invasive cases were localized at the time of diagnosis (89.6%; n = 439). At 10 years, patients with CIS and invasive disease had a similar relative cumulative survival (96.8% and 94.4%; P = .18).
IPC is a rare disease. There is no apparently significant difference in the long-term survival of patients in the 2 histologically derived subgroups of IPC. There is an excellent prognosis for patients diagnosed with IPC regardless of whether the tumor is diagnosed as in situ or invasive. Clinicians should keep this in mind when planning surgical and adjuvant treatments. Sentinel lymph node biopsy may be a prudent way to evaluate axillary involvement in patients with IPC.

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    • "The largest series of intracystic papillary carcinoma in the literature, with an analysis of over 900 cases of IPC, retrospectively from the data of the California Cancer Registry (CCR), reviewed from the years 1988 to 2005, demonstrate that distinguishing between in situ or invasive IPC is likely not of clinical significance because, regardless of the classification , the prognosis is excellent [7]. There are no evidence-based guidelines for treatment of IPC. "
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