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Papillary Carcinoma of the Breast

Etiology: • Unknown

Pathogenesis: • Unknown. ?BRCA1 mutations, see discussion under invasive carcinoma.

Epidemiology: • Approximately 1-2% of breast carcinoma

General Gross Description: • Usually 2-3 cms in size • Approximately 1/2 located beneath the nipple (associated with bloody nipple discharge) • Well-circumscribed • Cystic lesions contain brown mixture of blood clot and neoplastic tissue

General Microscopic Description: • Intracystic variant may be difficult to separate from papilloma but lack myoepithelial cell proliferation • Stroma of the papillae is delicate compared to a papilloma • Piled up epithelial cells with nuclear hyperchromasia and mitotic activitiy • Periphery of cyst is fibrotic and distinguishing invasion may be difficult unless neoplasm reaches fat

Clinical Correlations: • When non-invasive prognosis is similar to other intraductal carcinoma • When invasive carries a significantly better prognosis than usual ductal carcinoma

References: • Rosen PP, Oberman H. Tumors of the Mammary Gland. AFIP, Washington, 1993, pp. 209-218.