Encapsulated apocrine papillary carcinoma of the breast—a tumour of uncertain malignant potential: report of five cases

Seal, Melanie; Wilson, C. M.; Naus, Gregory J.; Chia, Stephen; Bainbridge, Terry C.; Hayes, Malcolm

doi:10.1007/s00428-009-0834-7

Cited by 30 publications

(34 citation statements)

References 26 publications

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“…The authors found that EPC-cells have a moderate to intense Collagen type-IV expression which is absent in the cells of the IDC. In conclusion, Esposito et al, confirmed that EPCs have an excellent prognosis and so local treatment alone may be sufficient to control the disease thoroughly Seal et al, (2009) [37]. in their study of five cases of EPC from British Columbia Cancer Agency, Vancouver, Canada, consider EPC as a tumour of uncertain malignant potential which should not be treated like invasive ductal carcinoma of the breast Calderaro et al, (2009) [10].…”

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confidence: 65%

Encapsulated papillary carcinoma of the breast: An overview

et al. 2013

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Any papillary growth of the breast presents both a diagnostic and a therapeutic challenge: For each one of them a diagnosis of whether they are malignant or benign in nature is required as well as appropriate staging and suitable treatment. In the international literature, we find a considerable amount of different terms being used for papillary breast growths. As a result, pathological and clinical evaluation is somewhat problematic. Encapsulated papillary carcinoma (EPC) is an interesting subgroup of breast papillary tumours. Because of its rarity, there have been only a limited number of large clinical studies that safely assess its appropriate treatment and expected outcome. However, more safe data exist in terms of prognosis - which seems to be excellent, as almost all published studies regarding these tumours have confirmed so far. We present a systematic overview of breast EPC and of the most important studies published on this topic in order to make diagnosis and treatment more straightforward for cancer clinicians. The information for this review was compiled by searching the Pubmed, Medline, Scopus, Embase, and ISI Web of Science databases for articles published from 1980 through December 2012. Electronic early-release publications were also included.

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confidence: 65%

Encapsulated papillary carcinoma of the breast: An overview

et al. 2013

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“…He described some benign apocrine papillary lesions of the breast lacking, or virtually lacking, MECs, a potential pitfall that should not be diagnosed as malignancy . Five cases of encapsulated apocrine papillary carcinoma of the breast were described by Seal et al ., with key histological features similar to those of classical encapsulated papillary carcinoma (EPC), including an absence of MECs both within the papillary structures and at the periphery. Cases were of pure apocrine appearance cytologically with variable degrees of atypia and mitotic activity.…”

Section: Observed Effects Of Lack Of Mecs On Epithelial Proliferativementioning

confidence: 99%

Invasion in breast lesions: the role of the epithelial–stroma barrier

et al. 2018

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Despite the significant biological, behavioural and management differences between ductal carcinoma in situ (DCIS) and invasive carcinoma of the breast, they share many morphological and molecular similarities. Differentiation of these two different lesions in breast pathological diagnosis is based typically on the presence of an intact barrier between the malignant epithelial cells and stroma; namely, the myoepithelial cell (MEC) layer and surrounding basement membrane (BM). Despite being robust diagnostic criteria, the identification of MECs and BM to differentiate in-situ from invasive carcinoma is not always straightforward. The MEC layer around DCIS may be interrupted and/or show an altered immunoprofile. MECs may be absent in some benign locally infiltrative lesions such as microglandular adenosis and infiltrating epitheliosis, and occasionally in non-infiltrative conditions such as apocrine lesions, and in these contexts this does not denote malignancy or invasive disease with metastatic potential. MECs may also be absent around some malignant lesions such as some forms of papillary carcinoma, yet these behave in an indolent fashion akin to some DCIS. In Paget's disease, malignant mammary epithelial cells extend anteriorly from the ducts to infiltrate the epidermis of the nipple but do not typically infiltrate through the BM into the dermis. Conversely, BM-like material can be seen around invasive carcinoma cells and around metastatic tumour cell deposits. Here, we review the role of MECs and BM in breast pathology and highlight potential clinical implications. We advise caution in interpretation of MEC features in breast pathology and mindfulness of the substantive evidence base in the literature associated with behaviour and clinical outcome of lesions classified as benign on conventional morphological examination before changing classification to an invasive lesion on the sole basis of MEC characteristics.

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“…Other theories consider IPC to be a tumor in transition from an in-situ to an invasive phase[10–12]. Despite the inconsistencies in establishing the true biological nature of these tumors, given their indolent nature, the WHO working group recommends classifying and treating them as them as Tis (in-situ carcinoma) for staging purposes, unless they have a clearly invasive component[8,13,14]. …”

Section: Introductionmentioning

confidence: 99%

Intracystic papillary carcinoma of the breast: A SEER database analysis of implications for therapy

et al. 2016

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Background Intracystic papillary carcinoma (IPC) of the breast is a rare breast malignancy with an indolent course. However, patients can develop metastatic disease. Indications for surgery and radiotherapeutic management have not been well elucidated. Methods We identified 2,649 female patients with IPC from the Surveillance, Epidemiology, and End Results (SEER) registry. Differences in demographics, clinical features and survival of patients were assessed using the Kaplan-Meier method and Cox regression. Results Median age was 67 years. The majority of patients were white with Stage 0 disease. Most patients had lymph node evaluation and only 34% received radiation therapy. Using a log-rank test, survival was significantly better in Caucasian compared to African-American patients, patients with early stage disease, negative lymph nodes and those who received radiation (all p<0.0001). In a Cox regression survival model adjusting for age, stage and grade, patients who were African-American (hazard ratio [HR] 2.0, CI 1.4–2.8; p<0.0001) had a significantly higher risk of death than Caucasians. Patients who received radiation therapy (HR 0.5, CI 0.3–0.7; p=0.0003) had a lower chance of death than patients that did not undergo radiation. Conclusion Overall, IPC has a good prognosis. Survival is improved in Caucasian patients and in patients who receive radiation therapy. Radiation therapy should be offered to women with IPC who undergo breast conserving surgery.

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Encapsulated apocrine papillary carcinoma of the breast—a tumour of uncertain malignant potential: report of five cases

Cited by 30 publications

References 26 publications

Encapsulated papillary carcinoma of the breast: An overview

Encapsulated papillary carcinoma of the breast: An overview

Invasion in breast lesions: the role of the epithelial–stroma barrier

Intracystic papillary carcinoma of the breast: A SEER database analysis of implications for therapy

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