{"entity":{"id":"papillary-carcinoma-breast","kind":"cancer","name":"Papillary carcinomas of the breast (encapsulated, solid and invasive papillary)","aka":["Papillary carcinomas of the breast","Papillary carcinoma of the breast","Encapsulated papillary carcinoma","Intracystic papillary carcinoma","Solid papillary carcinoma","Invasive papillary carcinoma","Tall cell carcinoma with reversed polarity"],"tldr":"Papillary carcinomas are rare breast cancers, about one in a hundred, that grow as finger-like fronds on stalks, often inside a cyst, mostly in older women. The encapsulated and solid forms behave almost like non-invasive disease and have an excellent outlook; the truly invasive papillary form is treated like ordinary hormone-driven breast cancer.","summary":"The 2019 WHO classification groups four entities under papillary neoplasms: encapsulated papillary carcinoma (a papillary carcinoma within a cystic space surrounded by a fibrous capsule, with no myoepithelial layer), solid papillary carcinoma (in situ and invasive forms, often with neuroendocrine differentiation), invasive papillary carcinoma, and the new tall cell carcinoma with reversed polarity (Tan 2020). Papillary carcinoma makes up 0.5 to 1 percent of breast cancer; in 302 cases, solid papillary carcinoma was more often accompanied by conventional invasive carcinoma than the intracystic form, and lesions lacking a myoepithelial layer are regarded as a special low-grade form of invasion whose behaviour is nonetheless indolent (Rakha 2011). Tall cell carcinoma with reversed polarity (solid papillary carcinoma with reverse polarity) has cuboid or tall cells with eosinophilic cytoplasm at the basal pole, grooved nuclei, Ki-67 under 5 percent in seven of nine cases, CK5/6 and calretinin expression, and a favourable prognosis (Modern Pathology 2018).\n\nHow it differs from its parent: papillary carcinomas are cancers of older women, hormone-receptor positive and HER2-negative in the encapsulated and solid forms, with an outlook close to that of ductal carcinoma in situ; the pathology question (in situ or invasive) decides the treatment more than the stage.\n\nHow common: 0.5 to 1 percent of breast cancer (Rakha 2011).\n\nTreatment: encapsulated and solid papillary carcinoma without conventional invasion are managed like ductal carcinoma in situ with excision and consideration of radiotherapy and endocrine therapy; a conventional invasive component is staged and treated as HR-positive breast cancer on the parent page (Rakha 2011).","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Breast_cancer_classification","links":[{"label":"Tan 2020, Histopathology: the 2019 WHO classification of tumours of the breast","url":"https://doi.org/10.1111/his.14091"},{"label":"Rakha 2011, Am J Surg Pathol: encapsulated papillary carcinoma of the breast, 302 papillary carcinomas","url":"https://doi.org/10.1097/pas.0b013e31821b3f65"},{"label":"Modern Pathology 2018: solid papillary carcinoma with reverse polarity, nine cases","url":"https://doi.org/10.1038/s41379-018-0047-1"}],"tags":["subtype-page","wave4","breast"],"related":["breast-cancer","ductal-carcinoma-in-situ","breast-hr-positive","mucinous-carcinoma-breast","invasive-micropapillary-carcinoma-breast"],"cancers":[],"sections":[],"technologies":["endocrine-therapy"],"targets":[],"drugs":["tamoxifen"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"group":"breast","burden":"Papillary carcinoma accounts for 0.5 to 1 percent of breast cancer; in a review of 302 papillary carcinomas from three institutions, 208 (84 percent) were intracystic (encapsulated), 30 (12 percent) solid papillary and 9 papillary ductal carcinoma in situ (Rakha 2011).","subtypes":["Encapsulated (intracystic) papillary carcinoma, 84 percent of papillary carcinomas","Solid papillary carcinoma, in situ or invasive, often neuroendocrine","Invasive papillary carcinoma (luminal, HR-positive)","Tall cell carcinoma with reversed polarity (IDH2-mutated, favourable)"],"biomarkers":["Absence of a myoepithelial layer (encapsulated and solid forms)","Oestrogen and progesterone receptor positive, HER2 negative","Ki-67 (low)","Neuroendocrine markers in solid papillary carcinoma"],"standardOfCare":[{"setting":"Encapsulated or solid, no conventional invasion","approach":"Managed as ductal carcinoma in situ: excision, with radiotherapy and endocrine therapy considered.","refs":["ductal-carcinoma-in-situ","tamoxifen"]},{"setting":"With conventional invasive carcinoma","approach":"Treated as HR-positive breast cancer.","refs":["breast-hr-positive","endocrine-therapy"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"breast-cancer"},"route":"/cancers/papillary-carcinoma-breast/","neighbours":{"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"ductal-carcinoma-in-situ","kind":"cancer","name":"Ductal carcinoma in situ (DCIS)","route":"/cancers/ductal-carcinoma-in-situ/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"invasive-micropapillary-carcinoma-breast","kind":"cancer","name":"Invasive micropapillary carcinoma of the breast","route":"/cancers/invasive-micropapillary-carcinoma-breast/"},{"id":"mucinous-carcinoma-breast","kind":"cancer","name":"Mucinous carcinoma of the breast","route":"/cancers/mucinous-carcinoma-breast/"},{"id":"neuroendocrine-neoplasms-breast","kind":"cancer","name":"Neuroendocrine neoplasms of the breast","route":"/cancers/neuroendocrine-neoplasms-breast/"}],"technology":[{"id":"endocrine-therapy","kind":"technology","name":"Endocrine therapy (SERMs, AIs, SERDs)","route":"/technologies/endocrine-therapy/"}],"drug":[{"id":"tamoxifen","kind":"drug","name":"Tamoxifen","route":"/drugs/tamoxifen/"}]}}