Encapsulated papillary carcinoma of the breast: A single institution experience

Xu,Liang; Mao,Qixin; Liu,Qiuming; Gao,Yufeng; Luo,Lihua; Guo,Chungen; Qu,Wei; Yan,Ningning; Cao,Yali

doi:10.3892/ol.2023.14046

Encapsulated papillary carcinoma of the breast: A single institution experience

Authors:
- Liang Xu
- Qixin Mao
- Qiuming Liu
- Yufeng Gao
- Lihua Luo
- Chungen Guo
- Wei Qu
- Ningning Yan
- Yali Cao
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Affiliations: Prevention and Cure Center of Breast Disease, The Third Hospital of Nanchang City, Nanchang, Jiangxi 330009, P.R. China, Department of Breast Disease, Henan Breast Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450002, P.R. China, Department of Medical Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450002, P.R. China
Published online on: September 7, 2023 https://doi.org/10.3892/ol.2023.14046
Article Number: 459
Copyright: © Xu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Encapsulated papillary carcinoma (EPC) is a relatively rare form of breast cancer. To date, no evidence‑based guidelines for the treatment of EPC have been established. Between January 2015 and December 2021, patients with histologically confirmed EPC of the breast were recorded in a database by The Third Hospital of Nanchang City (Nanchang, China). A total of 46 patients with EPC were retrieved from the database. Age at diagnosis ranged from 41‑88 years (median age, 62 years). A total of 21 of these patients had pure EPC, 6 patients had EPC associated with ductal carcinoma in situ and 19 patients had EPC associated with invasive carcinoma. The majority of EPC cases were low nuclear grade, hormone receptor‑positive and human epidermal growth factor receptor‑2‑negative. Additionally, myoepithelial cells were always absent in the papillae of the EPC. All patients underwent lumpectomy or mastectomy with sentinel lymph node biopsy, and almost all of the patients received adjuvant hormonal therapy. Adjuvant chemotherapy was only suggested to 4 patients who were diagnosed with axillary lymph node involvement. Subsequently, the clinicopathological features of non‑invasive EPC were compared with invasive EPC. The results indicated that larger tumor sizes and axillary lymph node metastases were more common in invasive tumors. During the follow‑up, only 2 patients with invasive EPC experienced recurrence or metastasis. In conclusion, a substantial proportion of invasive EPC cases display aggressive characteristics and metastatic potential, despite it being considered a subtype of carcinoma in situ with excellent prognosis, and local surgical resection is the initial method of treatment. Therefore, adjuvant endocrine therapy, radiotherapy and chemotherapy should be considered in select patients, especially in those diagnosed with invasive EPC tumors.

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1	Salemis NS and Mourtzoukou D: Encapsulated papillary carcinoma of the breast. Breast J. 27:280–283. 2021. View Article : Google Scholar : PubMed/NCBI
2	George K, Anna Z, Evanthia K and Vassilios K: Encapsulated papillary carcinoma of the breast: An overview. J Cancer Res Ther. 9:564–570. 2013. View Article : Google Scholar : PubMed/NCBI
3	Steponavičienė L, Gudavičienė D, Briedienė R, Petroška D and Garnelytė A: Diagnosis, treatment, and outcomes of encapsulated papillary carcinoma: A single institution experience. Acta Med Litu. 25:66–75. 2018.PubMed/NCBI
4	Masood S: The significance of accurate diagnosis of encapsulated papillary carcinoma of the breast by core needle biopsy. Breast J. 27:207–208. 2021. View Article : Google Scholar : PubMed/NCBI
5	Kitahara M, Hozumi Y, Takeuchi N, Ichinohe S, Fujiwara S, Machinaga M, Saitoh H and Iijima T: Distant metastasis after surgery for encapsulated papillary carcinoma of the breast: A case report. Case Rep Oncol. 13:1196–1201. 2020. View Article : Google Scholar : PubMed/NCBI
6	Mulligan AM and O'Malley FP: Metastatic potential of encapsulated (intracystic) papillary carcinoma of the breast: A report of 2 cases with axillary lymph node micrometastases. Int J Surg Pathol. 15:143–147. 2007. View Article : Google Scholar : PubMed/NCBI
7	Tariq MU, Idress R, Qureshi MB and Kayani N: Encapsulated papillary carcinoma of breast; a clinicopathological study of 25 cases and literature review with emphasis on high grade variant. Ann Diagn Pathol. 49:1516132020. View Article : Google Scholar : PubMed/NCBI
8	Jackson CR, Felty CC, Marotti JD, Rosenkranz KM and Muller KE: Encapsulated papillary carcinoma with and without frank invasion: Comparison of clinicopathologic features and role of axillary staging. Breast J. 27:209–215. 2021. View Article : Google Scholar : PubMed/NCBI
9	Grabowski J, Salzstein SL, Sadler GR and Blair S: Intracystic papillary carcinoma: A review of 917 cases. Cancer. 113:916–920. 2008. View Article : Google Scholar : PubMed/NCBI
10	Hashmi AA, Iftikhar SN, Munawar S, Shah A, Irfan M and Ali J: Encapsulated papillary carcinoma of breast: Clinicopathological features and prognostic parameters. Cureus. 12:e112822020.PubMed/NCBI
11	Patel A, Hoda RS and Hoda SA: Papillary breast tumors: Continuing controversies and commentary on WHO's 2019 criteria and classification. Int J Surg Pathol. 30:124–137. 2022. View Article : Google Scholar : PubMed/NCBI
12	Yamamoto Y, Hayashi Y, Sakaki H and Murakami I: Downregulation of fascin induces collective cell migration in triple-negative breast cancer. Oncol Rep. 50:1502023. View Article : Google Scholar : PubMed/NCBI
13	Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, Bilous M, Ellis IO, Fitzgibbons P, Hanna W, et al: Human epidermal growth factor receptor 2 testing in breast cancer: American society of clinical oncology/college of American pathologists clinical practice guideline focused update. Arch Pathol Lab Med. 142:1364–1382. 2018. View Article : Google Scholar : PubMed/NCBI
14	Jacobs TW, Gown AM, Yaziji H, Barnes MJ and Schnitt SJ: Comparison of fluorescence in situ hybridization and immunohistochemistry for the evaluation of HER-2/neu in breast cancer. J Clin Oncol. 17:1974–1982. 1999. View Article : Google Scholar : PubMed/NCBI
15	Hassan Z, Boulos F, Abbas J, El Charif MH, Assi H and Sbaity E: Intracystic papillary carcinoma: Clinical presentation, patterns of practice, and oncological outcomes. Breast Cancer Res Treat. 182:317–323. 2020. View Article : Google Scholar : PubMed/NCBI
16	Li X, Xu Y, Ye H, Qin S, Hou F and Liu W: Encapsulated papillary carcinoma of the breast: A clinicopathological study of 49 cases. Curr Probl Cancer. 42:291–301. 2018. View Article : Google Scholar : PubMed/NCBI
17	Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, Bilous M, Ellis IO, Fitzgibbons P, Hanna W, et al: Human epidermal growth factor receptor 2 testing in breast cancer: American society of clinical oncology/college of American pathologists clinical practice guideline focused update. J Clin Oncol. 36:2105–2122. 2018. View Article : Google Scholar : PubMed/NCBI
18	Schwartz CJ, Boroujeni AM, Khodadadi-Jamayran A, Heguy A, Snuderl M, Jour G, Cotzia P and Darvishian F: Molecular analysis of encapsulated papillary carcinoma of the breast with and without invasion. Hum Pathol. 111:67–74. 2021. View Article : Google Scholar : PubMed/NCBI
19	Solanki MH, Derylo AF, Visotcky AM and Jorns JM: Encapsulated and solid papillary carcinomas of the breast: Tumors in transition from in situ to invasive? Breast J. 25:539–541. 2019. View Article : Google Scholar : PubMed/NCBI
20	Romics L Jr, O'Brien ME, Relihan N, O'Connell F and Redmond HP: Intracystic papillary carcinoma in a male as a rare presentation of breast cancer: A case report and literature review. J Med Case Rep. 3:132009. View Article : Google Scholar : PubMed/NCBI
21	Brents M and Hancock J: Ductal carcinoma in situ of the male breast. Breast Care (Basel). 11:288–290. 2016. View Article : Google Scholar : PubMed/NCBI
22	Rehman B, Mumtaz A, Sajjad B, Urooj N, Khan SM, Zahid MT, Mannan H, Chaudhary MZ, Khan A and Parvaiz MA: Papillary carcinoma of breast: Clinicopathological characteristics, management, and survival. Int J Breast Cancer. 2022:54278372022. View Article : Google Scholar : PubMed/NCBI
23	Morgan S, Dodington D, Wu JM and Turashvili G: Solid papillary carcinoma and encapsulated papillary carcinoma of the breast: Clinical-pathologic features and basement membrane studies of 50 cases. Pathobiology. 88:359–373. 2021. View Article : Google Scholar : PubMed/NCBI
24	Galea MH, Blamey RW, Elston CE and Ellis IO: The Nottingham prognostic index in primary breast cancer. Breast Cancer Res Treat. 22:207–219. 1992. View Article : Google Scholar : PubMed/NCBI
25	Liu X, Wu H, Teng L, Zhang H, Lu J and Liang Z: High-grade encapsulated papillary carcinoma of the breast is clinicopathologically distinct from low/intermediate-grade neoplasms in Chinese patients. Histol Histopathol. 34:137–147. 2019.PubMed/NCBI
26	Rakha EA, Varga Z, Elsheik S and Ellis IO: High-grade encapsulated papillary carcinoma of the breast: An under-recognized entity. Histopathology. 66:740–746. 2015. View Article : Google Scholar : PubMed/NCBI
27	Athanasiou A, Khomsi F, de Joliniere B and Feki A: Encapsulated papillary carcinoma: A case report and review of the literature. Front Surg. 8:7438812022. View Article : Google Scholar : PubMed/NCBI
28	Yee C, Drost L, Niglas M, Chow E and Vesprini D: Early local recurrence in a patient with encapsulated papillary carcinoma of the breast. Clin Breast Cancer. 18:e447–e448. 2018. View Article : Google Scholar : PubMed/NCBI
29	Kang HJ, Kwon SY, Kim A, Kim WG, Kim EK, Kim AR, Kim C, Min SK, Park SY, Sung SH, et al: A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification. J Pathol Transl Med. 55:380–387. 2021. View Article : Google Scholar : PubMed/NCBI
30	Zheng L, Saluja K and Guo T: Invasive lobular carcinoma mimicking encapsulated papillary carcinoma with a literature review: A rare variant detected serendipitously. Int J Surg Pathol. 30:912–920. 2022. View Article : Google Scholar : PubMed/NCBI
31	Motanagh SA and Muller KE: Invasive lobular carcinoma with papillary features: A newly described variant that poses a difficult histologic differential diagnosis. Breast J. 26:1231–1233. 2020. View Article : Google Scholar : PubMed/NCBI
32	Kurtoğlu Özçağlayan Tİ and Öznur M: Digital mammography, ultrasound and magnetic resonance imaging characteristics in differential diagnosis of papillary carcinoma subtypes of the breast and diagnostic challenges. Eur J Breast Health. 18:172–181. 2022. View Article : Google Scholar : PubMed/NCBI
33	Tang CY, Guan PS, You QQ, Yuan HX and Wang WP: Contrast-enhanced ultrasound combined with ultrasonic elastography to diagnose encapsulated papillary carcinoma: A case report. Clin Hemorheol Microcirc. 82:391–396. 2022. View Article : Google Scholar : PubMed/NCBI
34	Tariq N, Mamoon N, Usman M, Ali Z and Nazir I: Encapsulated papillary carcinoma (EPC) of breast: A clinical, pathological and immunohistochemical analysis of eight cases. J Pak Med Assoc. 66:1490–1493. 2016.PubMed/NCBI
35	Lazzeroni M, Dunn BK, Pruneri G, Jereczek-Fossa BA, Orecchia R, Bonanni B and DeCensi A: Adjuvant therapy in patients with ductal carcinoma in situ of the breast: The Pandora's box. Cancer Treat Rev. 55:1–9. 2017. View Article : Google Scholar : PubMed/NCBI
36	Giuliano AE, Edge SB and Hortobagyi GN: Eighth edition of the AJCC cancer staging manual: Breast cancer. Ann Surg Oncol. 25:1783–1785. 2018. View Article : Google Scholar : PubMed/NCBI