Introduction/Background Intracystic papillary carcinoma (IPC) is a rare breast malignancy with an excellent prognosis However, it remains a poorly understood neoplasm. this study aims to evalute its clinio-pathological features and outcome at our institution.
Methodology We retrospectively reviewed the clinical record of 6 patients treated for an IPC of the breast at Salah Azaiez Institut Tunisia between 2017 and 2022
Results All the patients were postmenopausal females with a mean age of 71.5 years old presenting with a palpable mass. The average tumor size was 25mm with a maximum of 150mm. Mammography and ultrasonography showed a well circumscribed mass with cystic or solido-cystic component in most cases.
The most common stage at presentation was stage II disease. Only one patient was metastatic to the bone and liver at presentation.
5 patients underwent radical surgery associated with axillary lymph node dissection in 4 cases and sentinel lymph node dissection in one case.
At the final pathologic report, 83.3% of cases were classified as carcinoma in situ whereas only one case was invasive. All axillary lymph nodes were negative. Immunohistochemical studies revealed the positivity of hormonal receptors in approximately 83% of cases. Hormonal Epidermal Growth factor receptor 2 was only evaluated in 2 cases and proved to be negative.
Exclusive hormonal therapy was indicated in all the cases. The average duration of follow-up was 16 months (range from 7 to 63 ) with no evidence of local or distant relapse.
Conclusion IPC is a rare breast malignancy that shares features with both ductal carcinoma in situ (DCIS) and invasive ductal carcinoma. It should be staged and managed like DCIS with surgery as the standard of management. It carries an indolent behavior with a low frequency of axillary lymph node involvement, rare distant metastases, and excellent survival. A meta-analysis of the litterature is primordial to standardize the treatment.
Disclosures the authors have nothing to diclose.
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