Intracystic papillary carcinoma (breast)

Last revised by Gerard Carbo on 13 Aug 2021

An intracystic papillary carcinoma of the breast is a type of papillary carcinoma of the breast. It accounts for a significant proportion of intracystic breast cancers.

As with papillary carcinomas in general, it tends to occur in postmenopausal women.

Pathologically, intracystic papillary carcinomas may show four cellular patterns:

  • cribriform
  • compact columnar epithelial
  • stratified spindle cell
  • transitional cell form resembling urothelium

The combination of two or more of these patterns may also be seen.

Some report value in measuring CEA levels in the aspirated cyst fluid 3.

On mammography, an intracystic papillary carcinoma is often seen as a round or oval circumscribed mass, most frequently in the retroareolar region.

The usual ultrasound appearance is a cystic mass, with or without septations, with solid papillary masses projecting into the cyst lumen.

A segmental mastectomy is usually performed, and axillary lymph node sampling (axillary lymph node dissection or sentinel lymph node mapping) is suggested in patients in whom invasion is likely.

Intracystic papillary carcinoma has a slow growth rate and an excellent prognosis with 10-year survival rates approaching 100% 1,2.

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