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Review
. 2023 May;12(10):11408-11416.
doi: 10.1002/cam4.5855. Epub 2023 Mar 31.

Encapsulated papillary carcinoma of the breast: An institutional case series and literature review

Hiang Jin Tan  1   2 , Puay Hoon Tan  3   4 , Lester Chee Hao Leong  5 , Veronique Kiak Mien Tan  1   2   4   6 , Benita Kiat Tee Tan  1   2   4   6   7 , Sue Zann Lim  1   2   4   6 , Madhukumar Preetha  1   2   4   6 , Chow Yin Wong  1   2   4 , Wei Sean Yong  1   2   4   6 , Yirong Sim  1   2   4   6
Affiliations
Review

Encapsulated papillary carcinoma of the breast: An institutional case series and literature review

Hiang Jin Tan et al. Cancer Med. 2023 May.

Abstract

Background: Encapsulated papillary carcinoma of the breast is rare, making difficult diagnosis and resulting in patients undergoing excision biopsy before definitive surgery. Evidence-based guidelines are sparse. We would like to further elucidate the clinicopathological, treatment and survival outcomes.

Materials and methods: 54 patients identified, with a median follow up duration of 48 months. Patients' demographics, radiological and clinicopathological characteristics, treatment, adjuvant therapies as well as survival data were analysed.

Results: 18 (33.3%) cases were pure EPC, 12 (22.2%) were EPC associated with ductal carcinoma in situ (DCIS) and 24 (44.4%) cases had concurrent invasive ductal carcinoma. EPCs were more likely to present as a solid-cystic mass on sonography (63.8%), regular-shaped (oval or round) (97.9%), lack spiculations (95.7%) and lack suspicious microcalcifications (95.6%). Median tumour size was largest in the EPC with IDC group (18.5 mm). 2 patients developed loco-regional recurrence. Overall survival is good for EPCs of all subtypes.

Conclusion: EPC is a rare tumour with excellent prognosis.

Keywords: breast; encapsulated; papillary.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Kaplen Meier curve showing overall survival for all 3 groups – Pure EPC, EPC with DCIS and EPC with IDC.
FIGURE 2
FIGURE 2
Ultrasound image showing a complex solid‐cystic mass containing an eccentric mural solid component. The margins are partly ill‐defined.
FIGURE 3
FIGURE 3
Pure EPC that shows a thick fibrous capsule around coalescent and anastomosing papillary fronds.
FIGURE 4
FIGURE 4
EPC (right field) with DCIS (left field). DCIS showed a solid pattern with necrosis, low to intermediate nuclear grade, adjacent to an encapsulated papillary carcinoma. Both DCIS and encapsulated papillary carcinoma cells disclosed relatively ample pink cytoplasm reminiscent of apocrine morphology.
FIGURE 5
FIGURE 5
Encapsulated papillary carcinoma shows a fibrous wall and an area of haemorrhage within the tumour. To the left of the encapsulated papillary carcinoma is an area of invasive carcinoma (arrow), where there are crowded tubules within a fibrous stroma.
See this image and copyright information in PMC

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