What are papillary carcinomas of the breast?

Updated: May 24, 2018
  • Author: Peter Abdelmessieh, DO, MSc; Chief Editor: Marie Catherine Lee, MD, FACS  more...
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Answer

Answer

Papillary carcinoma of the breast encompasses a spectrum of histologic subtypes. There are two common types: cystic (noninvasive form) and micropapillary ductal carcinoma (invasive form). Papillary breast cancer is usually seen in women older than 60 years and accounts for approximately 1-2% of all breast cancers. Papillary carcinomas are centrally located in the breast and can present as bloody nipple discharge. They are strongly estrogen receptor (ER) positive and progesterone receptor (PR) positive.

Cystic papillary carcinoma has a low mitotic activity, which results in a more indolent course and a good prognosis. However, invasive micropapillary ductal carcinoma has a more aggressive phenotype, even though approximately 70% of cases are ER positive. A retrospective review of 1,400 cases of invasive carcinoma identified 83 cases (6%) with at least one component of invasive micropapillary ductal carcinoma.

Additionally, lymph node metastasis is seen frequently in this subtype (70-90% incidence), and the number of lymph nodes involved appears to correlate with survival.


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