Cancer Breast Cancer More Subtypes An Overview of Papillary Carcinoma of the Breast By Pam Stephan Pam Stephan is a breast cancer survivor. Learn about our editorial process Pam Stephan Medically reviewed by Medically reviewed by Doru Paul, MD on August 19, 2019 Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology. Learn about our Medical Review Board Doru Paul, MD Updated on January 08, 2020 Print Table of Contents View All Symptoms Causes Diagnosis Treatment Papillary carcinoma of the breast, also known as intraductal papillary carcinoma, is a rare type of breast cancer that accounts for only 0.5% of all new cases of invasive breast cancers. It is defined by finger-like projections called papules, which can be seen when cells are examined under a microscope. Many papillary tumors are not cancerous; these are called papillomas. When papillary tumors are malignant, it is because they include both in situ cells, which haven’t spread outside the duct, and invasive cells that have begun to spread. Alexander Traksel / Getty Images Papillary carcinomas are most often diagnosed in women who have already gone through menopause. Interestingly, diagnoses of papillary carcinoma in men appear to be higher than that of other types of male breast cancer. While concerning, papillary carcinoma of the breast is less likely to affect the lymph nodes, is more responsive to treatment, and may offer a better prognosis than other types of invasive ductal cancers. Invasive cancers begin growing into the milk ducts of the breast and move to invade fibrous or fatty issue outside the duct. Symptoms Some papillary carcinomas may create a lump large enough to feel with the fingers, and that may cause breast tenderness. Discharge is also possible. Often, papillary carcinomas don't cause any symptoms and are not caught with breast self-examination. Rather, papillary carcinoma is usually found during a routine mammogram (breast imaging), appearing as a well-defined mass behind or just beyond the areola. Routine breast screening in the form of annual mammograms is the best way to identify papillary breast carcinoma before any symptoms are evident. Signs of Early, Metastatic, and Inflammatory Breast Cancer Causes Anyone can develop papillary carcinoma of the breast; researchers do not really know what causes it to develop. However, some people have an increased risk for this type of breast cancer. You may have an increased risk if: You are female: Papillary breast carcinoma can affect men, but women are at greater risk.You are over age 60 and/or post-menopausal: Papillary breast cancers are more common in women in their 60s and women of any age who are post-menopausal.You are African-American: Research shows that breast cancer mortality rates are significantly higher for black women than for Caucasian women. What Is Known About the Causes of Breast Cancer Diagnosis Papillary breast cancer is diagnosed much like other types of breast cancer. Imaging alone is not enough to make a diagnosis of papillary breast carcinoma, so mammograms, ultrasound, and/or breast magnetic resonance imaging (MRI) are done in conjunction tissue biopsy. A tissue biopsy for papillary breast carcinoma involves taking a sample of the tumor and examining it under a microscope. The cancer cells' finger-like appearance is what distinguishes them from cells that would be apparent in other types of breast cancer.Papillary carcinoma is often found with ductal carcinoma in situ (DCIS), which is a type of early stage breast cancer confined to a milk duct. Misdiagnosis Papillary carcinoma is sometimes misdiagnosed as intraductal papilloma or papillomatosis. Intraductal papilloma is a non-cancerous condition in which a tiny, wart-like growth in breast tissue punctures a duct. Intraductal papillomas grow inside the breast's milk ducts and may cause benign nipple discharge. Papillomatosis is a kind of hyperplasia, another non-cancerous condition that may occur in the ducts and cause cells to grown larger and faster than normal. Having one or more intraductal papillomas, or papillomatosis, slightly increases your risk of developing breast cancer. Treatment Most cases of papillary carcinoma are low-grade, slow-growing cancers for which the recovery rate is good. Many do not spread very far beyond their original site. That said, treatment is important. Options depend on various features of the cancer, including: Size of the tumor (papillary breast tumors are often small)Tumor grade (how quickly cells divide and if other types of cells are involved)Hormone receptor statusHER2 status Papillary breast tumors are often positive for estrogen and/or progesterone receptors (ER/PR+) and negative for the HER2 receptor. Surgery Lumpectomy, removal of the non-invasive cancer with a margin of surrounding tissue, or mastectomy, removal of all breast tissue (including the nipple and the areola) may be considered. Radiation Radiation is usually given after a lumpectomy to reduce the risk of the cancer coming back in the same breast. It may also be given to the lymph nodes in the arm, especially after a mastectomy and if the breast cancer is invasive. Drug Therapies Chemotherapy destroys cells and may be offered depending on tumor grade, hormone receptor and HR status, and if lymph nodes are affected. Hormone therapy drugs, on the other hand, can block the effect of estrogen on cancer cells. Papillary breast cancer cells will be tested to determine if estrogen binds to them. If it does, hormone therapy can be helpful. Targeted therapies also block the growth and spread of cancer cells. The most widely used target therapy is Herceptin (trastuzumab). Herceptin has been found to be very effective for treating HER2-positive breast cancers. It is not helpful for HER2-negative cancers, however. Finally, bisphosphonates—bone-building drugs found to help reduce the risk of invasive breasts cancers in post-menopausal women—can also be helpful in preventing cancer cells from spreading. How Breast Cancer Is Treated A Word From Verywell Cancer support groups are a great resource for finding people who have first-hand experience with a breast cancer diagnosis. Just be prepared that you may not meet someone else who has papillary carcinoma of the breast, given how rare it is. Connecting with others coping with breast cancer diagnosis and going through treatment can be invaluable. When it comes to discussing the specifics of your condition, however, your best resource remains your healthcare team. Was this page helpful? Thanks for your feedback! Get honest information, the latest research, and support for you or a loved one with breast cancer right to your inbox. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Pal SK, Lau SK, Kruper L, et al. Papillary carcinoma of the breast: an overview. Breast Cancer Res Treat 2010;122(3):637-45. doi:10.1007/s10549-010-0961-5 Steponavičienė L, Gudavičienė D, Briedienė R, Petroška D, Garnelytė A. Diagnosis, treatment, and outcomes of encapsulated papillary carcinoma: a single institution experience. Acta Med Litu. 2018;25(2):66–75. doi:10.6001/actamedica.v25i2.3759 Baquet CR, Mishra SI, Commiskey P, Ellison GL, DeShields M. Breast cancer epidemiology in blacks and whites: disparities in incidence, mortality, survival rates and histology. J Natl Med Assoc. 2008;100(5):480–488. doi:10.1016/s0027-9684(15)31294-3 American Cancer Society. Intraductal papillomas of the breast. Updated September 10, 2019. Wilson FR, Coombes ME, Brezden-Masley C, et al. Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis. Syst Rev. 2018;7(1):191. Published 2018 Nov 14. doi:10.1186/s13643-018-0854-y Goldvaser H, Amir E. Role of Bisphosphonates in Breast Cancer Therapy. Curr Treat Options Oncol. 2019;20(4):26. Additional Reading American Cancer Society. Non-cancerous Breast Conditions. Ingle SB, Murdeskwar HG, & Siddiqui S. Papillary carcinoma of breast: Minireview. World J Clin Cases. Jan 16, 2016; 4(1): 20-24. doi:10.12998/wjcc.v4.i1.20. Mogal H, Brown DR, Isom S, et al. Intracystic papillary carcinoma of the breast: A SEER database analysis of implications for therapy. The Breast, 2016; 27, 87–92. doi:10.1016/j.breast.2016.01.003.