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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Available from: Georgia Robins Sadler, Dec 14, 2013
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    • "% of adenoid cystic carcinomas of the breast display the t ( 6 ; 9 ) translocation , which leads to the fusion of MYB with NFIB ( Persson et al . , 2009 ; Wetterskog et al . , 2012 ) . Papillary carcinoma ( PC ) is a rare ( <1% ) special histologic type of breast cancer that often affects postmenopausal women and has an overall favorable outcome ( Grabowski et al . , 2008 ; Pal et al . , 2010 ; Rakha et al . , 2011 ; Solorzano et al . , 2002 ; Weigelt et al . , 2010a ) . PCs comprise a morphologi - cally heterogeneous group of lesions , all of which share a growth pattern characterized by the presence of arborescent fibrovascular stalks lined by a layer of neoplastic epithelial cells devoid of an interve"
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    ABSTRACT: Integrative genomic and transcriptomic characterization of papillary carcinomas of the breast, Molecular Oncology (2014), doi: 10.1016/j.molonc.2014.06.011. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
    Molecular Oncology 06/2014; DOI:10.1016/j.molonc.2014.06.011 · 5.94 Impact Factor
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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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    ABSTRACT: Intracystic papillary carcinoma is a rare malignant tumor of the breast. It occurs communally in postmenopausal women. Clinically it can be asymptomatic or manifested by a breast mass or a nipple discharge. On imaging intracystic papillary carcinoma has usually benign features. Pathologic diagnosis can be difficult at classical histological examination and identification of myoepithelial cells layer by immunohistochemical study can be useful. In the majority of cases of pure intracystic papillary carcinoma, conservative management is possible. Adjuvant therapy is still controversial and prognosis is excellent. We report three cases of intracystic papillary carcinoma diagnosed on immunohistochemical examination and managed with conservative surgery.
    02/2012; 2012:979563. DOI:10.1155/2012/979563
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    ABSTRACT: Intracystic papillary carcinoma which has a better prognosis than ductal carci-noma is a rare tumor of breast. A 50-year-old female was admitted to hospital with palpable mass on her left breast, which was mainly a cystic lesion including a solid component, with regular margin, and 2.5 cm in dimension on ultrasound examination. Fine needle aspiration biopsy of the solid component of 1.3 cm inside the cyst showed proliferative papillary structures with atypia. The patient underwent segmental mastectomy. Papillary carcinoma was detected on fro-zen section examination and sentinel lymph node biopsy was applied due to the doubt of invasive carcinoma. Intracystic papillary carcinoma was ascertained on postopertive histopathological examination. Intracystic papillary carcinoma should be recalled in the evaluation and diff erantial diagnosis of cystic lesions detected on postmenopausal women. Segmental mastectomy is suggested in the treatment of intracystic papillary carcinoma. However, there is no consensus as to performing sentinel node biopsy and adjuvant therapy.
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