Papillary Carcinoma of the Breast

Papillary carcinoma is a type of ductal carcinoma in situ (DCIS). This type of breast cancer is rarely invasive and usually stays within the milk ducts of your breast. Papilla (a projection) refers to the microscopic shape of the cancer cells, which resemble fingers, or threads.

This type of breast cancer is diagnosed in only 1% to 2% of all patients, which are usually older women, and in rare cases, in men.

It is also known as intraductal papillary carcinoma, solid papillary carcinoma

Intraductal papilloma is a non-cancerous condition in which a tiny wart-like growth in breast tissue punctures a duct. Intraductal papillomas grow inside your breast's milk ducts and can cause benign nipple discharge. Papillomatosis is a kind of hyperplasia (cells growing larger and faster than normal), another non-cancerous condition which can occur in your ducts. Having one or more intraductal papillomas, or having papillomatosis, slightly increases your risk of developing breast cancer.

Intracystic or intraductal papillary carcinoma may not be felt during your breast self-exam but could show up on a routine mammogram as a well-defined mass behind or just beyond your areola. Some intracystic papillary carcinomas may create a lump that is large enough to feel with your fingers, and the lump may cause some breast tenderness. Most papillary carcinomas don't cause any symptoms.

Papillary carcinoma can be difficult to distinguish by using imaging techniques alone. A tissue sample is usually required to get an accurate diagnosis. These screenings and tests may be done:

• Mammogram
• Ultrasound
• Tissue Biopsy – fine needle, core needle, or open surgical biopsy
• Sentinel Node Biopsy – if metastasis is a concern

Most cases of papillary carcinoma are low-grade, slow-growing cancers, for which your recovery rate is good. Many papillary carcinomas do not spread very far beyond their original site.

Treatment will depend on the size and location of the cancer, and your hormone status.

• Lumpectomy – removal of a non-invasive cancer with a margin of surrounding tissue
• Mastectomy – removal of the breast tissue and the invasive cancer
• Radiation
• Tamoxifen - for hormone-sensitive cancer