Intracystic papillary carcinoma (breast)

An intracystic papillary carcinoma of the breast is a type of papillary carcinoma of the breast. It accounts for a significant proportion of intracystic breast cancers.

Epidemiology

As with papillary carcinomas in general, it tends to occur in postmenopausal women.

Pathology

Pathologically, intracystic papillary carcinomas may show four cellular patterns:

  • cribriform
  • compact columnar epithelial
  • stratified spindle cell
  • transitional cell form resembling urothelium

The combination of two or more of these patterns may also be seen.

Markers

Some report value in measuring CEA levels in the aspirated cyst fluid .

Radiographic features

Mammography

On mammography, an intracystic papillary carcinoma is often seen as a round or oval circumscribed mass, most frequently in the retroareolar region.

Breast ultrasound

The usual ultrasound appearance is a cystic mass, with or without septations, with solid papillary masses projecting into the cyst lumen.

Treatment and prognosis

A segmental mastectomy is usually performed, and axillary lymph node sampling (axillary lymph node dissection or sentinel lymph node mapping) is suggested in patients in whom invasion is likely.

Intracystic papillary carcinoma has a slow growth rate and an excellent prognosis with 10-year survival rates approaching 100%.

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