Journal List > J Breast Cancer > v.11(2) > 1036126

J Breast Cancer. 2008 Jun;11(2):77-82. Korean.
Published online June 30, 2008.  https://doi.org/10.4048/jbc.2008.11.2.77
Copyright © 2008 Korean Breast Cancer Society
Clinicopathological Characteristics and Prognostic Factors of Papillary Carcinoma of the Breast
Seho Park,* Joo-Hee Kim,* Seokmo Kim, Byeong-Woo Park, and Kyong Sik Lee1
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
1Department of Surgery, Pochon CHA University College of Medicine, Seongnam, Korea.

Email: bwpark@yuhs.ac

*These authors contributed equally to the work presented here.

Received January 17, 2008; Accepted May 02, 2008.

Abstract

Purpose

Papillary carcinoma of the breast is a rare disease and accounts for 1-2% of all breast cancers. Because of its rarity, there have been no reports regarding prognostic factors of papillary carcinoma of the breast. The aim of this study was to review the clinicopathological factors and treatment modalities of papillary carcinoma of the breast and to evaluate the relationship between these factors and survival rates.

Methods

We retrospectively analyzed 31 patients diagnosed with papillary carcinoma of the breast from January 1986 to December 2005.

Results

The mean age of the patients was 53.5 yr. The most common symptom was a palpable mass (n=27). The mean size of a tumor was 3.5 cm and 41.9% of the patients were categorized as T2. Eighteen patients had node negative breast cancer. According to the TNM stage, there were 5, 5, 16 and 2 patients with stage 0, I, II and III disease, respectively. Expression of estrogen receptor and progesterone receptor were positive in 80.8% and 69.2% of the patients, respectively. Twenty-three patients underwent mastectomy and eight patients underwent breast-conserving surgery. Fourteen patients received chemotherapy, 20 patients received hormone therapy, and 10 patients received radiotherapy. The 10-yr disease-free survival rate and 10-yr overall survival rate were 74.9% and 86.1%, respectively. Axillary lymph node negative and an age under 50 yr were statistically significant factors in 5-yr disease-free survival and in 5-yr overall survival, respectively.

Conclusion

Papillary carcinoma of the breast showed a favorable outcome. Lymph node status and age were statistically significant factors for survival rates. The tumor size and stage had a relation with the survival rate, although the relation was not statistically significant.

Keywords: Breast; Papillary carcinoma; Prognosis

Figures


Fig 1
Microscopic findings of papillary carcinoma of the breast. Papillary carcinoma demonstrates a monotonous cellular proliferation with papillary architecture and nuclear hyperchromasia. The inset is a higher power of the carcinoma and reveals cellular pleomorphism and numerous mitoses (H&E stain, ×100).
Click for larger image


Fig 2
10-yr disease-free survival curve.
Click for larger image


Fig 3
10-yr overall survival curve.
Click for larger image

Tables


Table 1
Clinical characteristics of patients of papillary carcinoma of the breast
Click for larger image


Table 2
Pathological characteristics of tumor in papillary carcinoma of the breast
Click for larger image


Table 3
Treatment modality in papillary carcinoma of the breast
Click for larger image


Table 4
5-yr disease-free survival and 5-yr overall survival according to the clinicopathological factors and treatment modalities in papillary carcinoma of the breast
Click for larger image

References
1. Fisher ER, Palekar AS, Redmond C, Barton B, Fisher B. Pathologic findings from the national surgical adjuvant breast project (Protocol No.4) VI. Invasive papillary cancer. Am J Clin Pathol 1980;73:313–320.
2. Carter D. Intraductal papillary tumors of the breast. A study of 76 cases. Cancer 1977;39:1689–1692.
3. Devitt JE, Barr JR. The clinical recognition of cystic carcinoma of the breast. Surg Gynecol Obstet 1984;159:130–132.
4. Carter D, Orr SL, Merino MJ. Intracystic papillary carcinoma of the breast after mastectomy, radiotherapy or excisional biopsy alone. Cancer 1983;52:14–19.
5. Bansidhar BJ, Garguilo GA. Papillary carcinoma of the breast: characteristics and classification. Am Surg 2003;69:400–403.
6. Masood S, Barwick KW. Estrogen receptor expression of the less common breast carcinomas. Am J Clin Pathol 1990;93:437.
7. Kim DJ, Kim YS, Joo HC. Papillary carcinoma of the breast. J Korean Surg Soc 2000;59:8–14.
8. The Korean Breast Cancer Society. Survival analysis of Korean breast cancer patients diagnosed between 1993 and 2002 in Korea-a nationwide study of the cancer registry. J Breast Cancer 2006;9:214–229.
9. World Health Organization. Histological typing of breast tumors. Tumori 1982;68:181–198.
10. Czernobilsky B. Intracystic carcinoma of the female breast. Surg Gynecol Obstet 1967;124:93–98.
11. Kang HS, Kim YC, Noh DY, Park IA, Youn YK, Oh SK, et al. Histopathologic features of papillary cancer in breast. J Korean Surg Soc 1998;55:486–491.
12. Kim DJ, Kim YS, Joo HC. Papillary carcinoma of the breast. J Korean Surg Soc 2000;59:8–14.
13. Lefkowitz M, Lefkowitz W, Wargotz ES. Intraductal (intracystic) papillary carcinoma of the breast and its variants: a clinicopathologic study of 77 cases. Hum Pathol 1994;25:802–809.
14. Hunter CE Jr, Sawyers JL. Intracystic papillary carcinoma of the breast. South Med J 1980;73:1484–1486.
15. Rosen PP, Hoda SA. Papillary carcinoma. In: Rosen PP, Hoda SA, editors. Breast pathology diagnosis by needle core biopsy. Baltimore: Lippincott Williams & Wilkins; 2006. pp. 135-146.
16. McCulloch GL, Evans AJ, Yeoman L, Wilson ARM, Pinder SE, Ellis IO, et al. Radiological features of papillary carcinoma of the breast. Clin Radiol 1997;52:865–868.
17. Lam WW, Tang AP, Tse G, Chu WC. Radiology-pathology conference: papillary carcinoma of the breast. Clin Imaging 2005;29:396–400.
18. Ibarra JA. Papillary lesions of the breast. Breast J 2006;12:237–251.
19. Luna-More S, Gonzalez B, Acedo C, Rodrigo I, Luna C. Invasive micropapillary carcinoma of the breast. A new special type of invasive mammary carcinoma. Path Res Pract 1994;190:668–674.