Clinicopathologic analysis of solid papillary carcinoma of the breast and associated invasive carcinomas

Hind Nassar, Hina Qureshi, N. Volkan Adsay, Daniel W Visscher

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Solid papillary carcinomas (SPCs) are uncommon tumors composed of circumscribed large cellular nodules separated by bands of dense fibrosis. The aim of this study was to further elucidate the characteristics of SPC, the types and significance of invasive carcinomas associated with these tumors, and the long-term clinical outcome. Fifty-eight SPCs were analyzed (mean follow-up, 9.4 years). Cases were divided into three groups: 1) SPC only (32.7%), 2) SPC with extravasated mucin (8.6%), and 3) SPC with invasive components (58.7%) consisting of neuroendocrine-like (29.5%), colloid (23.5%), ductal not otherwise specified (14.5%), lobular (3%), tubular (3%), or mixed (26.5%). The mean age was 72 years. All were estrogen receptor positive and 86% were histologic grade 1. The total size of the tumor measured 0.3 to 15 cm. In the group with invasive carcinoma, the size of invasion was 0.1 to 4 cm. Axillary nodes were involved in 13% of the cases (6 of 46); all of these had an invasive component in the primary tumor. Local recurrence was seen in 5 patients, all from the group with invasive carcinoma. Overall, 11.7% died of their tumor, 1 to 4 years after diagnosis (mean, 2.3 years); none of them belongs to the group of noninvasive SPC. Five of the 6 patients who died of tumor had invasive components. The sixth patient who died with "metastatic signet-ring cell carcinoma" at 10 years was in the group of patients with SPC with extravasated mucin where the SPC lesion had prominent signet-ring cell features. In conclusion, SPCs are heterogeneous lesions that arise in older women and have an indolent behavior. Lymph node and distant metastases are uncommon and generally limited to cases with (conventional) invasive components.

Original languageEnglish (US)
Pages (from-to)501-507
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume30
Issue number4
DOIs
StatePublished - Apr 2006

Fingerprint

Papillary Carcinoma
Breast
Carcinoma
Neoplasms
Mucin-3
Signet Ring Cell Carcinoma
Colloids
Mucins
Estrogen Receptors
Fibrosis
Lymph Nodes
Neoplasm Metastasis
Recurrence

Keywords

  • Breast
  • Follow-up
  • Solid papillary carcinoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Clinicopathologic analysis of solid papillary carcinoma of the breast and associated invasive carcinomas. / Nassar, Hind; Qureshi, Hina; Adsay, N. Volkan; Visscher, Daniel W.

In: American Journal of Surgical Pathology, Vol. 30, No. 4, 04.2006, p. 501-507.

Research output: Contribution to journalArticle

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abstract = "Solid papillary carcinomas (SPCs) are uncommon tumors composed of circumscribed large cellular nodules separated by bands of dense fibrosis. The aim of this study was to further elucidate the characteristics of SPC, the types and significance of invasive carcinomas associated with these tumors, and the long-term clinical outcome. Fifty-eight SPCs were analyzed (mean follow-up, 9.4 years). Cases were divided into three groups: 1) SPC only (32.7{\%}), 2) SPC with extravasated mucin (8.6{\%}), and 3) SPC with invasive components (58.7{\%}) consisting of neuroendocrine-like (29.5{\%}), colloid (23.5{\%}), ductal not otherwise specified (14.5{\%}), lobular (3{\%}), tubular (3{\%}), or mixed (26.5{\%}). The mean age was 72 years. All were estrogen receptor positive and 86{\%} were histologic grade 1. The total size of the tumor measured 0.3 to 15 cm. In the group with invasive carcinoma, the size of invasion was 0.1 to 4 cm. Axillary nodes were involved in 13{\%} of the cases (6 of 46); all of these had an invasive component in the primary tumor. Local recurrence was seen in 5 patients, all from the group with invasive carcinoma. Overall, 11.7{\%} died of their tumor, 1 to 4 years after diagnosis (mean, 2.3 years); none of them belongs to the group of noninvasive SPC. Five of the 6 patients who died of tumor had invasive components. The sixth patient who died with {"}metastatic signet-ring cell carcinoma{"} at 10 years was in the group of patients with SPC with extravasated mucin where the SPC lesion had prominent signet-ring cell features. In conclusion, SPCs are heterogeneous lesions that arise in older women and have an indolent behavior. Lymph node and distant metastases are uncommon and generally limited to cases with (conventional) invasive components.",
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