Document Type : Case Reports
Authors
Dept. of Pathology, ESI PGIMSR& ESIC Medical College, Joka Kolkata, West Bengal, India
Abstract
Malignant papillary neoplasms of the breast comprise a number of microscopically distinct lesions, where apocrine metaplasia is commonly found in papillomas compared to other papillary lesions including papillary carcinomas. However, association of apocrine metaplasia in papilloma with Ductal Carcinoma in Situ (DCIS) is not very well defined. The lesions with apocrine metaplasia are not only difficult to categories, but also there is controversy regarding their relative risk of subsequent carcinoma development. A case of extensive apocrine differentiation in duct papilloma with DCIS developing in the background of papillomatosis, posing a diagnostic dilemma for the pathologist and a therapeutic challenge for the surgeon, is hereby reported for its uniqueness and rarity. Awareness of this association should be kept in mind by both the pathologist as well as clinician for optimal therapeutic intervention.
Keywords
- Mulligan AM, O’Malley FP. Papillary lesions of the breast: a review. Adv Anat Pathol 2007;14(2):108–19.
- Collins LC, Schnitt SJ. Papillary lesions of the breast: selected diagnostic and management issues. Histopathology 2008;52(1):20–9.
- Ueng SH, Mezzetti T, Tavassoli FA. Papillary neoplasms of the breast: a review. Arch Pathol Lab Med 2009 Jun;133(6):893–907.
- Wells CA and ElAyatNon GA. Operative breast pathology: apocrine lesions. J Clin Pathol 2007; 60(12): 1313–20.
- Grabowski J, Salzstein S L, Sadler G R, Blair S .Intracystic papillary carcinoma: a review of 917 cases .Cancer 2008 September 1; 113(5): 916–20.
- Trenkic S, Katc V, PashalinaM,ZivkovicV,Milentijevic M, Kostov M . The histologic spectrum of apocrine lesions of the breast. Arch Oncol 2004;12(1): 61-5.
- Debnath D, Al-Okati D, Ismail W.MultiplePapillomatosis of Breast and Patient’s Choice of Treatment. Pathol Res Int 2010; Article ID 540590 :doi:10.4061/2010/540590.
- Pal SK, Lau SK, KruperL,Nwoye U, Garberoglio C, Gupta RK, Paz B, VoraL,GuzmanE,Artinyan A, Somlo G. Papillary Carcinoma of the Breast: An Overview. Breast Cancer Res Treat 2010; 122(3): 637–45.
- Jones C, Damian Si, Wells D, Chaggar R, Lakhan S R, Euse V . Molecular Cytogenetic Comparison of Apocrine Hyperplasia and Apocrine Carcinoma of the Breast. Am J Pathol 2001; 158(1):1-4.
- Jaffer S, Nagi C, Bleiweiss IJ. Excision is indicated for intraductal papilloma of the breast diagnosed on core needle biopsy. Cancer 2009;115(13):2837–43.
- Harjit K, Willsher PC, Bennett M, Jackson LR, Metclaf C, Saunders CM. Multiple papillomas of the breast:is current management adequate? Breast 2006;15(6):777-81.
)