Intracystic papillary carcinoma - A review of 917 cases

University of California, San Diego, San Diego, California, United States
Cancer (Impact Factor: 4.89). 09/2008; 113(5):916-20. DOI: 10.1002/cncr.23723
Source: PubMed


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.
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    • "Clinically, however, the largest reported study of 917 cases carried out on IPC patients from California demonstrated that the relative cumulative survival rate was no different in the group of IPC alone or associated invasive cancer (P = 0.18 ) followed up at 10 years [16]. "
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    ABSTRACT: Intracystic (encysted) papillary cancer (IPC) is a rare entity of breast cancer accounting for approximately (1-2%) of all breast tumours [1], usually presenting in postmenopausal women and having an elusive natural history. The prediction of the biological behaviour of this rare form of breast cancer and the clinical outcome showed its overall favourable prognosis; however, its consideration as a form of ductal carcinoma in situ with non-invasive nature is to be reconsidered as it has been shown to present histologically with invasion of basement membrane and even metastasis [2]. The objective of this review is to shed some light on this rare, diagnostically challenging form of breast cancer, including its radiological, histological, and molecular characteristics and its pathological classification. The final goal is to optimize the clinical management including the role of sentinel lymph node biopsy (SLNB), general management with adjuvant radiotherapy (RT), mammary ductoscopy, and hormonal treatment. A literature review, facilitated by Medline, PubMed, and the Cochrane database, was carried out using the terms 'Intracystic (encysted) papillary breast cancer'. Intracystic papillary breast cancer (IPC) is best managed in the context of a multidisciplinary team. Surgical excision of the lump with margins in excess of 2 mm is considered satisfactory. Sentinel lymph node biopsy (SLNB) is recommended as data have shown the possibility of the presence of invasive cancer in the final histology. RT following IPC alone is of uncertain significance as this form of cancer is usually low grade and rarely recurs. However, if it is associated with DCIS or invasive cancer and found in young women, radiotherapy may be prudent to reduce local recurrence. Large tumours, centrally located or in cases where breast conserving surgery is unable to achieve a favourable aesthetic result, a skin sparing mastectomy with the opportunity for immediate reconstruction can be offered. Adjuvant endocrine therapy may be suggested as almost certainly these tumours are hormonal positive. Further research is required to determine the role of adjuvant radiotherapy and endocrine therapy in IPC. Understanding the low-grade nature of this form of breast cancer allows treatment options to be less radical and safely omitted.
    Full-text · Article · Jan 2013 · ecancermedicalscience
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