Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Frequently Asked Questions
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.Under a microscope, papillary carcinoma looks similar to fingerlike projections called papules. Many papillary tumors are not cancerous; these are called papillomas. Papillary tumors that are cancerous (malignant) include both in situ cells, meaning they haven’t spread outside the duct, and invasive cells, which have begun to spread.Alexander Traksel / Getty ImagesAlthough concerning, papillary carcinoma of the breast is less likely to spread to the lymph nodes, is more responsive to treatment, and may offer a better prognosis than other types of invasive ductal cancers.This article will cover the symptoms, causes, diagnosis, and treatment options for papillary carcinoma of the breast.Invasive cancers begin growing into the milk ducts of the breast and move to invade fibrous or fatty tissue outside the duct.Types of Papillary Breast CancerThere are several variations of papillary breast cancer.Benign (Noncancerous) Papillary LesionsIntraductal papilloma (solitary): A single tumor that grows in the milk ducts near the nippleIntraductal papillomatosis: Tumors that grow in the milk ducts near the nippleAtypical Papillary LesionsIntraductal papilloma with atypical hyperplasia: Abnormal growth of cellsPapilloma with ductal carcinoma in situ (DCIS), a precancerous conditionMalignant Papillary LesionsNoninvasive:Papillary DCIS: Begins in the milk duct of the breast, but hasn’t spread outside the ductEncapsulated papillary carcinoma: A rare tumor that is contained in one areaSolid papillary carcinoma: A rare form with solid nodules, mainly affecting older womenInvasive:Invasive papillary carcinoma: A very rare form of ductal carcinomaInvasive micropapillary carcinoma: A variant of breast carcinoma with a high chance for regional lymph node involvementSymptomsOften, papillary carcinomas don’t cause any symptoms and are not caught with breast self-examination.When they do cause symptoms, you may experience the following:A lump large enough to feel with the fingersNipple changes like the nipple turning inwardBreast tendernessDischargeBreast Cancer Signs and SymptomsCausesPapillary carcinomas are most often diagnosed in women who have already gone through menopause. Interestingly, diagnoses of papillary carcinoma in men appear to be more common than other types of male breast cancer.Anyone can develop papillary carcinoma of the breast; researchers do not really know what causes it to develop.Causes and Risk Factors of Breast CancerDiagnosisPapillary carcinoma is usually found during a routinemammogram(breast imaging), appearing as a well-defined mass behind or just next to the areola.Imaging tests alone are not enough to make a diagnosis of papillary breast carcinoma, so mammograms,ultrasound, and/orbreast magnetic resonance imaging (MRI)are done in conjunction withtissue biopsy.A tissue biopsy for papillary breast carcinoma involves taking a sample of the tumor and examining it under a microscope. The cancer cells' fingerlike appearance is what distinguishes them from cells that would be characteristic of other types of breast cancer.Papillary carcinoma is often found withDCIS, which is a type of early-stage breast cancer confined to a milk duct.MisdiagnosisPapillary carcinoma is sometimes misdiagnosed as intraductal papilloma or papillomatosis.Intraductal papillomais a noncancerous condition in which a tiny, wartlike growth in breast tissue punctures a duct. Intraductal papillomas grow inside thebreast’s milk ductsand may causebenign nipple discharge.Papillomatosisis a kind ofhyperplasia, another noncancerous condition that may occur in the ducts and cause cells to grow larger and faster than normal.Having one or more intraductal papillomas, or papillomatosis, slightly increases yourrisk of developing breast cancer.TreatmentMost cases of papillary carcinoma are low-grade, slow-growing cancers. 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 gradeHormone receptor statusHER2 (human epidermal growth factor receptor 2) statusPapillary breast tumors are oftenpositive for estrogen and/or progesterone receptors (ER/PR+) and negative for the HER2 receptor.SurgerySurgical options includelumpectomy, removal of the noninvasive cancer along with a margin of surrounding tissue, ormastectomy, removal of all breast tissue (including the nipple and the areola).Drug TherapiesChemotherapydestroys cells and may be offered depending on tumor grade, hormone receptor and HER2 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 therapiesalso block the growth and spread of cancer cells. The most widely used target therapy isHerceptin(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 cancer recurrence in postmenopausal women—can also be helpful in preventing cancer cells from spreading.How Breast Cancer Is TreatedSummaryPapillary carcinoma of the breast is a rare type of breast cancer that accounts for only 0.5% of all new cases of invasive breast cancers. It mostly affects women who have already gone through menopause. There may be no symptoms and you may not find a lump during a self-examination. This cancer is slow-growing and is not likely to spread to the lymph nodes.A Word From VerywellCancer support groupsare 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 who also are coping with a breast cancer diagnosis and going through treatment, however, can be invaluable.When it comes to discussing the specifics of your condition, however, your best resource remains your healthcare team.Frequently Asked QuestionsFamily history does play a role and knowing your family history is important. If you have a first-degree relative who has this cancer type, you may be at higher risk.Yes, like many types of breast cancer, this type starts in the milk ducts of the breast.This type of cancer is typically slow-growing and does not grow far from its original spot.Because this cancer is not likely to spread to the lymph nodes, it has a better outcome than some other invasive breast cancers.
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.
Under a microscope, papillary carcinoma looks similar to fingerlike projections called papules. Many papillary tumors are not cancerous; these are called papillomas. Papillary tumors that are cancerous (malignant) include both in situ cells, meaning they haven’t spread outside the duct, and invasive cells, which have begun to spread.
Alexander Traksel / Getty Images
Although concerning, papillary carcinoma of the breast is less likely to spread to the lymph nodes, is more responsive to treatment, and may offer a better prognosis than other types of invasive ductal cancers.
This article will cover the symptoms, causes, diagnosis, and treatment options for papillary carcinoma of the breast.
Invasive cancers begin growing into the milk ducts of the breast and move to invade fibrous or fatty tissue outside the duct.
Types of Papillary Breast Cancer
There are several variations of papillary breast cancer.
Benign (Noncancerous) Papillary Lesions
Atypical Papillary Lesions
Malignant Papillary Lesions
Noninvasive:
Invasive:
Often, papillary carcinomas don’t cause any symptoms and are not caught with breast self-examination.
When they do cause symptoms, you may experience the following:
Breast Cancer Signs and Symptoms
Papillary carcinomas are most often diagnosed in women who have already gone through menopause. Interestingly, diagnoses of papillary carcinoma in men appear to be more common than other types of male breast cancer.
Anyone can develop papillary carcinoma of the breast; researchers do not really know what causes it to develop.
Causes and Risk Factors of Breast Cancer
Papillary carcinoma is usually found during a routinemammogram(breast imaging), appearing as a well-defined mass behind or just next to the areola.
Imaging tests alone are not enough to make a diagnosis of papillary breast carcinoma, so mammograms,ultrasound, and/orbreast magnetic resonance imaging (MRI)are done in conjunction withtissue biopsy.
A tissue biopsy for papillary breast carcinoma involves taking a sample of the tumor and examining it under a microscope. The cancer cells' fingerlike appearance is what distinguishes them from cells that would be characteristic of other types of breast cancer.
Papillary carcinoma is often found withDCIS, 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 papillomais a noncancerous condition in which a tiny, wartlike growth in breast tissue punctures a duct. Intraductal papillomas grow inside thebreast’s milk ductsand may causebenign nipple discharge.
Papillomatosisis a kind ofhyperplasia, another noncancerous condition that may occur in the ducts and cause cells to grow larger and faster than normal.
Having one or more intraductal papillomas, or papillomatosis, slightly increases yourrisk of developing breast cancer.
Most cases of papillary carcinoma are low-grade, slow-growing cancers. Many do not spread very far beyond their original site. That said, treatment is important. Options depend on various features of the cancer, including:
Papillary breast tumors are oftenpositive for estrogen and/or progesterone receptors (ER/PR+) and negative for the HER2 receptor.
Surgery
Surgical options includelumpectomy, removal of the noninvasive cancer along with a margin of surrounding tissue, ormastectomy, removal of all breast tissue (including the nipple and the areola).
Drug Therapies
Chemotherapydestroys cells and may be offered depending on tumor grade, hormone receptor and HER2 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 therapiesalso block the growth and spread of cancer cells. The most widely used target therapy isHerceptin(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 cancer recurrence in postmenopausal women—can also be helpful in preventing cancer cells from spreading.
How Breast Cancer Is Treated
Summary
Papillary carcinoma of the breast is a rare type of breast cancer that accounts for only 0.5% of all new cases of invasive breast cancers. It mostly affects women who have already gone through menopause. There may be no symptoms and you may not find a lump during a self-examination. This cancer is slow-growing and is not likely to spread to the lymph nodes.
A Word From Verywell
Cancer support groupsare 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 who also are coping with a breast cancer diagnosis and going through treatment, however, can be invaluable.
When it comes to discussing the specifics of your condition, however, your best resource remains your healthcare team.
Frequently Asked QuestionsFamily history does play a role and knowing your family history is important. If you have a first-degree relative who has this cancer type, you may be at higher risk.Yes, like many types of breast cancer, this type starts in the milk ducts of the breast.This type of cancer is typically slow-growing and does not grow far from its original spot.Because this cancer is not likely to spread to the lymph nodes, it has a better outcome than some other invasive breast cancers.
Family history does play a role and knowing your family history is important. If you have a first-degree relative who has this cancer type, you may be at higher risk.
Yes, like many types of breast cancer, this type starts in the milk ducts of the breast.
This type of cancer is typically slow-growing and does not grow far from its original spot.
Because this cancer is not likely to spread to the lymph nodes, it has a better outcome than some other invasive breast cancers.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ingle SB, Murdeshwar HG, Siddiqui S.Papillary carcinoma of breast: Minireview.World J Clin Cases. 2016;4(1):20-24. doi:10.12998/wjcc.v4.i1.20Nuñez DL, González FC, Ibargüengoitia MC, et al.Papillary lesions of the breast: a review.Breast Cancer Management. 2020;9:4. doi.org/10.2217/bmt-2020-0028Steponavičienė 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.v25i2.3759Pal 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/s10549-010-0961-5American Cancer Society.Intraductal papillomas of the breast.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. doi:10.1186/s13643-018-0854-yGoldvaser H, Amir E.Role of bisphosphonates in breast cancer therapy.Curr Treat Options Oncol. 2019;20(4):26. doi:10.1007/s11864-019-0623-8.Ingle SB, Murdeshwar HG, Siddiqui S.Papillary carcinoma of breast: Minireview.World J Clin Cases. 2016;4(1):20-24. doi:10.12998/wjcc.v4.i1.20Additional ReadingAmerican 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.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ingle SB, Murdeshwar HG, Siddiqui S.Papillary carcinoma of breast: Minireview.World J Clin Cases. 2016;4(1):20-24. doi:10.12998/wjcc.v4.i1.20Nuñez DL, González FC, Ibargüengoitia MC, et al.Papillary lesions of the breast: a review.Breast Cancer Management. 2020;9:4. doi.org/10.2217/bmt-2020-0028Steponavičienė 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.v25i2.3759Pal 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/s10549-010-0961-5American Cancer Society.Intraductal papillomas of the breast.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. doi:10.1186/s13643-018-0854-yGoldvaser H, Amir E.Role of bisphosphonates in breast cancer therapy.Curr Treat Options Oncol. 2019;20(4):26. doi:10.1007/s11864-019-0623-8.Ingle SB, Murdeshwar HG, Siddiqui S.Papillary carcinoma of breast: Minireview.World J Clin Cases. 2016;4(1):20-24. doi:10.12998/wjcc.v4.i1.20Additional ReadingAmerican 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.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ingle SB, Murdeshwar HG, Siddiqui S.Papillary carcinoma of breast: Minireview.World J Clin Cases. 2016;4(1):20-24. doi:10.12998/wjcc.v4.i1.20Nuñez DL, González FC, Ibargüengoitia MC, et al.Papillary lesions of the breast: a review.Breast Cancer Management. 2020;9:4. doi.org/10.2217/bmt-2020-0028Steponavičienė 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.v25i2.3759Pal 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/s10549-010-0961-5American Cancer Society.Intraductal papillomas of the breast.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. doi:10.1186/s13643-018-0854-yGoldvaser H, Amir E.Role of bisphosphonates in breast cancer therapy.Curr Treat Options Oncol. 2019;20(4):26. doi:10.1007/s11864-019-0623-8.Ingle SB, Murdeshwar HG, Siddiqui S.Papillary carcinoma of breast: Minireview.World J Clin Cases. 2016;4(1):20-24. doi:10.12998/wjcc.v4.i1.20
Ingle SB, Murdeshwar HG, Siddiqui S.Papillary carcinoma of breast: Minireview.World J Clin Cases. 2016;4(1):20-24. doi:10.12998/wjcc.v4.i1.20
Nuñez DL, González FC, Ibargüengoitia MC, et al.Papillary lesions of the breast: a review.Breast Cancer Management. 2020;9:4. doi.org/10.2217/bmt-2020-0028
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
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
American Cancer Society.Intraductal papillomas of the breast.
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. 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. doi:10.1007/s11864-019-0623-8.
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.
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.
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