Breast
Other carcinoma subtypes, WHO classified
Invasive papillary


Topic Completed: 15 April 2021

Minor changes: 15 April 2021

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PubMed search: Invasive papillary carcinoma[TIAB] breast

Zena Jameel, M.D.
Marilin Rosa, M.D.
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Cite this page: Jameel Z, Rosa M. Invasive papillary. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastmalignantpapillary.html. Accessed April 19th, 2021.
Definition / general
Essential features
  • A rare subtype of invasive ductal carcinoma with infiltrative papillary growth
  • Imperative to distinguish it from other invasive and noninvasive mammary lesions, as well as extramammary tumors metastasizing to the breast
Terminology
  • Invasive papillary carcinoma (IPC)
ICD coding
  • ICD-O: 8503/3 - invasive papillary carcinoma
  • ICD-11:
    • XH8KR8 - papillary carcinoma of breast
    • 2C60 - carcinoma of breast, specialized type
Epidemiology
Sites
  • No specific location in the breast
Etiology
Clinical features
  • Due to the rarity of this tumor, specific clinical features have not been described
  • Typically presents with bloody nipple discharge, an abnormal mass or radiographic abnormalities
    • However, it is not clear if these features refer to true IPC or other types of papillary carcinomas misdiagnosed as IPC (J Surg Res 2021;261:105)
Diagnosis
  • Mammogram
  • Breast ultrasound (US)
  • Breast MRI
Radiology description
Prognostic factors
Case reports
Treatment
Gross description
Microscopic (histologic) description
Microscopic (histologic) images

Contributed by Marilin Rosa, M.D.
Invasive mixed papillary and micropapillary carcinoma

Invasive mixed papillary and micropapillary carcinoma

No surrounding fibrous capsule

No surrounding fibrous capsule

Desmoplasia

Desmoplasia

Invasive papillary carcinoma

Invasive papillary carcinoma

No surrounding fibrous capsule

No surrounding fibrous capsule


Invasive papillary fronds

Invasive papillary fronds

Invasive papillary carcinoma

Invasive papillary carcinoma

Papillae lack myoepithelial cells

Papillae lack myoepithelial cells

Necrosis and calcifications

Necrosis and calcifications

Mitotic figures

Mitotic figures

Sample pathology report
  • Right / left breast, mastectomy:
    • Invasive papillary carcinoma, Nottingham histologic grade (X), measuring (X) cm (please see detailed synoptic report)
    • Associated ductal carcinoma in situ (DCIS), (X) nuclear grade, (X) patterns, comprising X% of tumor (if present).
    • Lymphovascular invasion (is / is not) identified.
    • Biopsy site changes are identified.
    • Margins are (involved / uninvolved).
Differential diagnosis
Board review style question #1

Which of the following is a relevant feature of invasive papillary carcinoma of the breast (pictured lesion)?

  1. It has myoepithelial cells at the periphery
  2. It is a commonly encountered breast tumor
  3. It is graded according to nuclear size
  4. It is positive for Napsin A and PAX8
  5. It may mimic metastases from other organs
Board review style answer #1
E. It may mimic metastases from other organs (metastases to the breast from other organs such as ovary, lung and thyroid must be excluded)

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Reference: Invasive papillary carcinoma
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