Abstract | AIMS: Encapsulated papillary carcinoma ( EPC) is a recognized special type of breast carcinoma. Despite compelling evidence indicating its invasive nature, although not of a conventional form, the current consensus is to manage EPC as an in-situ disease, based on its indolent clinical behaviour. Although most EPCs are recognized to be of low and intermediate grade, a distinct proportion of these tumours do show high cytonuclear grade features. The existence and behaviour of these rare high-grade variants remains to be defined. We aim to characterise these tumours and provide evidence to guide their management. METHODS AND RESULTS: In this study, we have identified 12 high-grade EPCs without associated conventional stromal invasion. To further characterize these high-grade tumours, a series of invasive papillary carcinomas (n = 30) were assessed for the coexistence of EPC. The literature was also reviewed. Approximately 3% of pure EPCs showed high-grade features as defined by nuclear pleomorphism and increased mitotic activity. These tumours not only showed histological features associated with aggressive behaviour, but were also often hormone receptor-negative, tended to be of larger size, and were more frequently associated with stromal invasion. Of the 10 patients with follow-up data, one with pure high-grade EPC developed recurrence and died of her disease. CONCLUSION: High-grade EPC is rare, and its histological features and more aggressive clinical behaviour suggest that consideration should be given to managing it in a similar fashion to conventional forms of invasive breast carcinoma, based on established clinicopathological parameters.
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Authors | Emad A Rakha, Zsuzsanna Varga, Somaia Elsheik, Ian O Ellis |
Journal | Histopathology
(Histopathology)
Vol. 66
Issue 5
Pg. 740-6
(Apr 2015)
ISSN: 1365-2559 [Electronic] England |
PMID | 25382726
(Publication Type: Journal Article, Review)
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Copyright | © 2014 John Wiley & Sons Ltd. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms
(classification, pathology)
- Carcinoma, Papillary
(classification, pathology)
- Female
- Humans
- Middle Aged
- Retrospective Studies
- Staining and Labeling
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