scholarly journals Solid Papillary Carcinoma and Encapsulated Papillary Carcinoma of the Breast: Clinical-Pathologic Features and Basement Membrane Studies of 50 Cases

Pathobiology ◽  
2021 ◽  
pp. 1-15
Author(s):  
Sarah Morgan ◽  
David Dodington ◽  
Jessie M. Wu ◽  
Gulisa Turashvili
Keyword(s):  
Lymph Node ◽  
Papillary Carcinoma ◽  
Invasive Carcinoma ◽  
Lymph Node Involvement ◽  
Myoepithelial Cells ◽  
Favorable Prognosis ◽  
Solid Papillary Carcinoma ◽  
Pathologic Features ◽  
Node Involvement

<b><i>Introduction:</i></b> Solid papillary carcinoma (SPC) and encapsulated papillary carcinoma (EPC) of the breast are usually considered in situ lesions due to favorable prognosis, despite the variable presence of myoepithelial cells. We aimed to describe clinical-pathologic features including basement membrane (BM) studies in these tumors. <b><i>Methods:</i></b> Patients diagnosed with SPC and EPC in 2000–2019 were retrospectively identified. Microscopic slides and clinical history were reviewed. Immunohistochemical stains for BM and myoepithelial markers were performed. <b><i>Results:</i></b> Of 23 SPCs and 27 EPCs, there were 5/23 (21.7%) pure SPCs and 9/27 (33.3%) pure EPCs, while 4/23 (17.4%) and 12/27 (44.5%) were associated with ductal carcinoma in situ (DCIS), and 6/23 (26.1%) and 6/27 (22.2%) with invasive carcinoma, respectively; 8/23 (34.8%) SPCs were considered invasive. The median tumor size was 1.7 cm (range 0.1–16). All tumors were positive for hormone receptors and negative for HER2. Myoepithelial cells were absent in 20 tumors (40%) and focally present in 30 (60%). Collagen IV and laminin were negative in most invasive lesions, but they were expressed in 21/21 (100%) and 18/21 (85.7%) of EPCs without invasion, and 16/17 (94.1%) and 10/17 (58.8%) SPCs, including invasive SPCs, respectively. Lymph node involvement was identified in 3/26 (11.5%) patients, including micrometastasis in 1 EPC associated with DCIS, macrometastasis in 1 EPC associated with invasive carcinoma, and isolated tumor cells in 1 invasive SPC. Of 31 patients with outcome data (median follow-up 35 months, range 1–85), 2 (6.5%; 1 SPC, 1 EPC) developed local recurrence, both associated with invasive carcinoma. No distant recurrences or deaths were observed. <b><i>Conclusions:</i></b> Our study confirms favorable prognosis of SPCs and EPCs, with 2 local recurrences occurring in the presence of invasion. SPCs are more commonly associated with invasive carcinoma or considered invasive compared to EPCs (60.9 vs. 22.2%). The presence of BM material and lack of lymph node involvement in most cases indicates that the majority of these tumors may represent in situ lesions; however, some may behave as low-grade invasive malignancy with metastatic potential even in the absence of conventional invasion.

scholarly journals Case report of adenoid cystic carcinoma of the breast – a rare lesion with favorable prognosis

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Juliana Lopes de Aguiar Araujo ◽  
Ubiratan Wagner de Sousa ◽  
Wender Batista de Sousa ◽  
Iris Maria Rodrigues de Andrade Almeida ◽  
Luisa Gurgel de Lira
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Adenoid Cystic Carcinoma ◽  
Axillary Dissection ◽  
Triple Negative ◽  
Lymph Node Involvement ◽  
Myoepithelial Cells ◽  
Cystic Degeneration ◽  
Adenoid Cystic ◽  
Node Involvement

Introduction: Adenoid cystic carcinoma (ACC) is a rare type of breast tumor – less than 0.1% of breast malignancies. Usually, ACC is triple-negative, with lymph node involvement not exceeding 2%, and metastases are uncommon. When localized, the disease is indolent with an excellent prognosis. Objective: To report a case of ACC of the breast and provide data for the medical literature. Method/Case report: J.S.M.S., 44 years old, had a 1 cm nodule in the right breast (RB) and free axillae. Mammography (MMG) showed focal asymmetry in the upper outer quadrant (UOQ) and BI-RADS 0. Ultrasound (US) revealed a solid, circumscribed, periareolar lesion with areas of cystic degeneration, 1.2 cm, BI-RADS 3. Fine-needle aspiration biopsy (FNAB) suggested fibroadenoma. Lesion resection led to the diagnosis of ACC, histological grade 1 (HG1), nuclear grade 1 (NG1), with associated ductal carcinoma in situ (DCIS), and sentinel lymph node with no neoplasia. Immunohistochemistry (IHC) revealed estrogen receptor-negative (ER-), progesterone receptor-negative (PR-), HER2 negative (HER2-), and Ki67 10%. Staging had no evidence of distant disease. The patient did not receive chemotherapy (CT) but underwent 18 sessions of radiotherapy (RT) in the breast with a boost to the tumor bed. She remains disease-free at 8 months of follow-up. Results/Discussion: ACC has low malignant potential with histology similar to that of primary ACC of the salivary gland (which is aggressive); in the breast, it represents 0.058% of all ACC cases. It is more common in Caucasian women aged 60 to 70 years and usually subareolar (approximately 50% of cases). Imaging tests are nonspecific. ACC has lymph node involvement in about 2% of cases. Histology shows epithelial and myoepithelial cells distributed in the classic tubular or cribriform architecture. IHC reveals epithelial cells positive for CD117 and myoepithelial cells positive for smooth muscle actin, calponin, and p63. ACC of the breast expresses proto-oncogene c-KIT and a chromosomal translocation similar to its salivary counterpart: t (6; 9) (q22-23; p23-24). Treatment consists of surgery with free margins. Axillary dissection, CT, and RT have a questionable role due to the indolent course of the disease. Until now, small studies have not suggested a benefit in overall survival when adding adjuvant CT. Although triple-negative, its prognosis is favorable. Local recurrence is approximately 3–18%, and 10-year survival is above 90%. Conclusion: The rarity of these tumors and their favorable course raise questions about the best treatment for ACC. The benefit of axillary dissection, CT, or RT remains unknown because the prognosis seems very favorable with only surgery, despite its triple-negative status. Further studies are necessary to adopt the optimal strategy for these tumors.

Sentinel Lymph Node Involvement in Ductal Carcinoma In-Situ of the Breast: Two Different Causes

2012 ◽  
Vol 12 (5) ◽  
pp. 378-381
Author(s):  
Olivier Brouckaert ◽  
Anneleen Reynders ◽  
Kathleen Vanderstappen ◽  
Ann Smeets ◽  
Ann Hoeben ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lymph Node Involvement ◽  
Node Involvement

Artefactual Epithelial Displacement in a Papilloma with Extensive Usual Duct Hyperplasia Mimics a Solid Papillary Carcinoma with Invasive Growth

2021 ◽  
pp. 106689692199158
Author(s):  
Aline François ◽  
Christine Galant ◽  
Martine Berlière ◽  
Mieke R. Van Bockstal
Keyword(s):  
Papillary Carcinoma ◽  
Invasive Carcinoma ◽  
Myoepithelial Cells ◽  
High Grade ◽  
Biopsy Needle ◽  
Nuclear Atypia ◽  
Solid Papillary Carcinoma ◽  
Needle Tract ◽  
Cytokeratin 5 ◽  
Immunohistochemical Profile

Mammary solid papillary carcinoma and usual duct hyperplasia (UDH) of the breast are morphological look-alikes, characterized by cellular streaming, solid growth, and a lack of high-grade nuclear atypia. Here, we report a challenging papillary lesion in the breast of a 48-year-old woman that presented with a double pitfall. A core needle biopsy showed a solid papillary proliferation of epithelial cells with oval to round overlapping nuclei, surrounded by a sclerotic stroma. This distorted lesion contained peripheral clefts and cellular streaming, without high-grade nuclear atypia. Immunohistochemistry showed diffuse heterogenous immunoreactivity for estrogen receptor and cytokeratin 5, and no immunoreactivity for chromogranin and synaptophysin. The immunohistochemical profile distinguished this sclerosed papilloma with extensive UDH from a solid papillary carcinoma. The lumpectomy specimen revealed a second challenge, where multiple epithelial islets without surrounding myoepithelial cells were observed near the papilloma, mimicking an invasive carcinoma. These islets displayed the same immunohistochemical profile as the sclerosed papilloma and they were surrounded by steatonecrosis and reactive fibroblasts, indicating epithelial displacement within the biopsy needle tract. A sclerosed papilloma with extensive UDH is a morphologically challenging mimic of a solid papillary carcinoma. Immunohistochemistry is helpful to distinguish both entities from one another. Extensive epithelial displacement in the biopsy tract made this case particularly challenging, as the displaced epithelial islets mimicked an invasive carcinoma. Pathologists should be aware of this uncommon double pitfall to prevent misdiagnosis.

scholarly journals Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5423
Author(s):  
Vincent Balaya ◽  
Benedetta Guani ◽  
Julie Mereaux ◽  
Laurent Magaud ◽  
Basile Pache ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Stage ◽  
Figo Stage ◽  
Lymph Node Involvement ◽  
Lymph Node Status ◽  
Pathologic Features ◽  
Early Stage Cervical Cancer ◽  
Node Involvement

Background: The prognosis of patients with cervical cancer is significantly worsened in case of lymph node involvement. The goal of this study was to determine whether pathologic features in conization specimens can predict the sentinel lymph node (SLN) status in early-stage cervical cancer. Methods: An ancillary analysis of two prospective multicentric database on SLN biopsy for cervical cancer (SENTICOL I and II) was carried out. Patients with IA to IB2 2018 FIGO stage, who underwent preoperative conization before SLN biopsy were included. Results: Between January 2005 and July 2012, 161 patients from 25 French centers fulfilled the inclusion criteria. Macrometastases, micrometastases and Isolated tumor cells (ITCs) were found in 4 (2.5%), 6 (3.7%) and 5 (3.1%) patients respectively. Compared to negative SLN patients, patients with micrometastatic and macrometastatic SLN were more likely to have lymphovascular space invasion (LVSI) (60% vs. 29.5%, p = 0.04) and deep stromal invasion (DSI) ≥ 10 mm (50% vs. 17.8%, p = 0.04). Among the 93 patients with DSI < 10 mm and absence of LVSI on conization specimens, three patients (3.2%) had ITCs and only one (1.1%) had micrometastases. Conclusions: Patients with DSI < 10 mm and no LVSI in conization specimens had lower risk of micro- and macrometastatic SLN. In this subpopulation, full node dissection may be questionable in case of SLN unilateral detection.

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