Intracystic papillary carcinoma: clinical presentation, patterns of practice, and oncological outcomes

• Published in: Breast cancer research and treatment Vol. 182; no. 2; pp. 317 - 323
• Main Authors: Hassan, Zeina, Boulos, Fouad, Abbas, Jaber, El Charif, Mohamad Hadi, Assi, Hazem, Sbaity, Eman
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2020; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Axilla; Biopsy; Breast; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - epidemiology; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Cancer; Cancer research; Carcinoma; Carcinoma, Intraductal, Noninfiltrating - diagnosis; Carcinoma, Intraductal, Noninfiltrating - epidemiology; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Intraductal, Noninfiltrating - therapy; Carcinoma, Papillary - diagnosis; Carcinoma, Papillary - epidemiology; Carcinoma, Papillary - pathology; Carcinoma, Papillary - therapy; Care and treatment; Chemotherapy, Adjuvant; Clinical Trial; ErbB-2 protein; Female; Follow-Up Studies; Humans; Immunohistochemistry; Lymph nodes; Lymphatic system; Mammary Glands, Human - pathology; Mammary Glands, Human - surgery; Mastectomy; Medical History Taking; Medical records; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Invasiveness - diagnosis; Neoplasm Invasiveness - pathology; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - prevention & control; Oncology; Patient outcomes; Patients; Post-menopause; Postmenopausal women; Prognosis; Retrospective Studies; Sentinel Lymph Node - pathology; Sentinel Lymph Node Biopsy; Statistical analysis; Thyroid cancer; Treatment Outcome; Intracystic/encysted papillary carcinoma; Pure IPC; IPC with associated invasive carcinoma; IPC with associated DCIS
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-020-05680-9

Background Intracystic/encapsulated papillary carcinoma remains a poorly understood disease of the breast with a little amount of reports that describe it. It shares features with DCIS and IDC and predominantly affects postmenopausal women. This study aims to evaluate the clinical presentation, treatment, and outcomes in IPC patients managed at our institution. Methods We retrospectively pooled twenty-eight IPC patients’ medical records at our institution. Descriptive analysis of clinicopathological characteristics, approach, and outcomes was done along with a quantitative statistical analysis. Results Cases were divided into three groups: isolated IPC, IPC associated with DCIS, and IPC associated with Invasive Carcinoma. Treatment modalities varied according to the IPC type and its associated components. All patients presented with a palpable mass. Immunohistochemical staining revealed that all isolated IPCs were ER and PR positive and HER2 negative. Lymph node dissection proved necessary only in IPC associated invasive carcinoma. Irregular borders and lobulations, among others, were found on non-invasive core biopsies that turned out to be associated with invasion on surgical pathology. All patients were alive after a median follow-up time of 23 months when the study was over with no reports of recurrence. Conclusion IPC cases and treatment approaches at our institution appear similar to the available literature and confirm the excellent prognosis among IPC. Even more, further studies into the key features such as BMI, family history, and radiological findings are necessary for a potential algorithm that could assess for risk of finding invasion in surgical pathology and subsequently the need for axillary/sentinel lymph node biopsy.