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

Abstract

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.

Intracyctic Papillary Carcinoma of the Breast: Report of a Rare Case and Literature Review

“…Some studies have demonstrated the lack of myoepithelial cell markers at the periphery and also existence of tumor foci beyond the fibrous capsule of the cysts as evidences of invasion (14,15). Even metastatic disease can occur and the most common site is lymph node (16,17). This case was another evidence for confirmation of the theory that invasive component can exist in encysted papillary tumors.…”

<p>Magnetic Resonance Imaging (MRI) Phenotypes May Provide Additional Information for Risk Stratification for Encapsulated Papillary Carcinoma of the Breast</p>

“…Encapsulated papillary carcinoma (EPC) of the breast, also commonly referred to as intracystic papillary carcinoma or encysted papillary carcinoma, is a rare breast cancer subtype, accounting for 0.5% to 2.0% of all breast tumors. 1,2 EPC has been considered a variant of ductal carcinoma in the past. The latest World Health Organization (WHO) Working Group's classification of breast tumors defines EPC as a separate subtype of papillary lesions that are characterized by a fibrous capsule surrounding the tumor, typically without a layer of myoepithelial cells.…”

“…The latest World Health Organization (WHO) Working Group's classification of breast tumors defines EPC as a separate subtype of papillary lesions that are characterized by a fibrous capsule surrounding the tumor, typically without a layer of myoepithelial cells. 2,3 According to the latest edition of the WHO Classification of Tumors of the Breast published in 2019, 4 EPC is classified into encapsulated papillary carcinoma and encapsulated papillary carcinoma with invasion. Several studies have demonstrated that the classification has clear prognostic significance, suggesting that the prognosis of EPC is excellent compared with that of EPC with invasion.…”

Encapsulated Papillary Carcinoma of The Breast: A Case Series

“…The surgical treatment of EPC is not controversial, but the optimal surgical method has not been determined yet because of the low incidence of this disease. The three commonly used methods of surgical treatment are modi ed radical mastectomy, mastectomy combined with sentinel lymph node biopsy (SLNB), and breast-conservation therapy with or without SLNB [10,14]. In the present case report, two patients received breast-conservation therapy.…”