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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.
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).
How 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.
How common: 0.5 to 1 percent of breast cancer (Rakha 2011).
Treatment: 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).
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).
Most cancers start in the ducts and drain first to the axillary nodes, which is why the armpit is checked and a sentinel node is sampled.
Same organ: Triple-negative breast cancer (TNBC), Breast cancer (all types), HR-positive / HER2-negative breast cancer, HER2-positive breast cancer, Male breast cancer, Ductal carcinoma in situ (DCIS), High-risk early HR-positive breast cancer, HR-positive metastatic breast cancer after CDK4/6 inhibitors, HER2-low and HER2-ultralow metastatic breast cancer, Early HER2-positive breast cancer, HER2-positive breast cancer with brain metastases, Early triple-negative breast cancer, Metastatic triple-negative breast cancer, Basal-like 1 triple-negative breast cancer (BL1), Basal-like 2 triple-negative breast cancer (BL2), Mesenchymal triple-negative breast cancer (M), Mesenchymal stem-like triple-negative breast cancer (MSL), Luminal androgen receptor triple-negative breast cancer (LAR), Immunomodulatory triple-negative breast cancer (IM), Metaplastic breast carcinoma, Carcinoma with medullary pattern (medullary breast cancer), Adenoid cystic carcinoma of the breast, Apocrine carcinoma of the breast, Secretory carcinoma of the breast, BRCA-associated triple-negative breast cancer, Inflammatory breast cancer, Paget disease of the nipple, Phyllodes tumour of the breast, Invasive lobular carcinoma of the breast, Invasive breast carcinoma of no special type (invasive ductal carcinoma), Tubular carcinoma of the breast, Mucinous carcinoma of the breast, Invasive cribriform carcinoma of the breast, Invasive breast carcinoma with medullary pattern (medullary carcinoma), Invasive micropapillary carcinoma of the breast, Neuroendocrine neoplasms of the breast, Lobular carcinoma in situ (LCIS)
Managed as ductal carcinoma in situ: excision, with radiotherapy and endocrine therapy considered.
Treated as HR-positive breast cancer.
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Query for this cancer: (TITLE:"Papillary carcinomas of the breast" OR ABSTRACT:"Papillary carcinomas of the breast" OR TITLE:"encapsulated, solid and invasive papillary" OR ABSTRACT:"encapsulated, solid and invasive papillary" OR TITLE:"Papillary carcinoma of the breast" OR ABSTRACT:"Papillary carcinoma of the breast" OR TITLE:"Encapsulated papillary carcinoma" OR ABSTRACT:"Encapsulated papillary carcinoma" OR TITLE:"Intracystic papillary carcinoma" OR ABSTRACT:"Intracystic papillary carcinoma" OR TITLE:"Solid papillary carcinoma" OR ABSTRACT:"Solid papillary carcinoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Papillary carcinomas of the breast (encapsulated, solid and invasive papillary), not a curated reading list.
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