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Breast
Histopathologic Diagnoses
Malignant Lesions
Encapsulated Papillary Carcinoma
Encapsulated Papillary Carcinoma
Wendie A. Berg, MD, PhD, FACR, FSBI; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Encapsulated papillary carcinoma (EPC)

            • Synonyms

              • Intracystic papillary carcinoma

            • Definitions

              • Carcinoma with papillary architecture consisting of papillae with fibrovascular cores within single circumscribed cystic space; fibrous capsule; lacks myoepithelial layer as in invasive carcinomas, but clinical behavior parallels in situ carcinoma

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • Ductography

                    • MR Findings

                      • Image-Guided Biopsy

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Jiang T et al: Magnetic resonance imaging features of breast encapsulated papillary carcinoma. J Comput Assist Tomogr. 42(4):536-41, 2018
                                              2. Li X et al: Encapsulated papillary carcinoma of the breast: a clinicopathological study of 49 cases. Curr Probl Cancer. 42(3):291-301, 2018
                                              3. Steponavičienė L et al: Diagnosis, treatment, and outcomes of encapsulated papillary carcinoma: a single institution experience. Acta Med Litu. 25(2):66-75, 2018
                                              4. Yee C et al: Early local recurrence in a patient with encapsulated papillary carcinoma of the breast. Clin Breast Cancer. 18(4):e447-8, 2018
                                              5. Rakha EA et al: Papillary carcinoma of the breast: diagnostic agreement and management implications. Histopathology. 69(5):862-70, 2016
                                              6. Tariq N et al: Encapsulated papillary carcinoma (EPC) of breast: a clinical, pathological and immunohistochemical analysis of eight cases. J Pak Med Assoc. 66(11):1490-3, 2016
                                              7. George K et al: Encapsulated papillary carcinoma of the breast: an overview. J Cancer Res Ther. 9(4):564-70, 2013
                                              8. Dhebri AR et al: Intracystic papillary carcinoma of breast: report of three cases and review of the literature. BMJ Case Rep. 2012, 2012
                                              9. Eiada R et al: Papillary lesions of the breast: MRI, ultrasound, and mammographic appearances. AJR Am J Roentgenol. 198(2):264-71, 2012
                                              10. Jakate K et al: Papillary lesions of the breast: impact of breast pathology subspecialization on core biopsy and excision diagnoses. Am J Surg Pathol. 36(4):544-51, 2012
                                              11. Rakha EA et al: Encapsulated papillary carcinoma of the breast: a study of invasion associated markers. J Clin Pathol. 65(8):710-14, 2012
                                              12. Bhargava R et al: Intracystic papillary carcinomas of the breast are more similar to in situ carcinomas than to invasive carcinoma. Am J Surg Pathol. 35(5):778-9; author reply 779-81, 2011
                                              13. Kamyab A et al: Intracystic papillary carcinoma with associated intraductal carcinoma of the breast in a male. Am Surg. 77(12):E267-8, 2011
                                              14. Rakha EA et al: Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. Am J Surg Pathol. 35(8):1093-103, 2011
                                              15. Wynveen CA et al: Intracystic papillary carcinoma of the breast: an in situ or invasive tumor? Results of immunohistochemical analysis and clinical follow-up. Am J Surg Pathol. 35(1):1-14, 2011
                                              16. Linda A et al: Unusual malignant tumors of the breast: MRI features and pathologic correlation. Eur J Radiol. 75(2):178-84, 2010
                                              17. Rodríguez MC et al: Best cases from the AFIP: intracystic papillary carcinoma of the breast. Radiographics. 30(7):2021-7, 2010
                                              18. Yoo JL et al: Can MR imaging contribute in characterizing well-circumscribed breast carcinomas? Radiographics. 30(6):1689-702, 2010
                                              19. Tse GM et al: The role of immunohistochemistry in the differential diagnosis of papillary lesions of the breast. J Clin Pathol. 62(5):407-13, 2009
                                              20. Grabowski J et al: Intracystic papillary carcinoma: a review of 917 cases. Cancer. 113(5):916-20, 2008
                                              21. Collins LC et al: Intracystic papillary carcinomas of the breast: a reevaluation using a panel of myoepithelial cell markers. Am J Surg Pathol. 30(8):1002-7, 2006
                                              22. Mercado CL et al: Papillary lesions of the breast at percutaneous core-needle biopsy. Radiology. 238(3):801-8, 2006
                                              23. Carder PJ et al: Needle core biopsy can reliably distinguish between benign and malignant papillary lesions of the breast. Histopathology. 46(3):320-7, 2005
                                              24. Hill CB et al: Myoepithelial cell staining patterns of papillary breast lesions: from intraductal papillomas to invasive papillary carcinomas. Am J Clin Pathol. 123(1):36-44, 2005
                                              25. Yang WT et al: Sonographic, mammographic, and histopathologic correlation of symptomatic ductal carcinoma in situ. AJR Am J Roentgenol. 182(1):101-10, 2004
                                              26. Liberman L et al: Case 35: intracystic papillary carcinoma with invasion. Radiology. 219(3):781-4, 2001
                                              27. Liberman L et al: Percutaneous large-core biopsy of papillary breast lesions. AJR Am J Roentgenol. 172(2):331-7, 1999
                                              28. McCulloch GL et al: Radiological features of papillary carcinoma of the breast. Clin Radiol. 52(11):865-8, 1997
                                              29. Soo MS et al: Papillary carcinoma of the breast: imaging findings. AJR Am J Roentgenol. 164(2):321-6, 1995
                                              30. Kraus FT et al: The differential diagnosis of papillary tumors of the breast. Cancer. 15:444-55, 1962
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Encapsulated papillary carcinoma (EPC)

                                                        • Synonyms

                                                          • Intracystic papillary carcinoma

                                                        • Definitions

                                                          • Carcinoma with papillary architecture consisting of papillae with fibrovascular cores within single circumscribed cystic space; fibrous capsule; lacks myoepithelial layer as in invasive carcinomas, but clinical behavior parallels in situ carcinoma

                                                        IMAGING

                                                        • General Features

                                                          • Mammographic Findings

                                                            • Ultrasonographic Findings

                                                              • Ductography

                                                                • MR Findings

                                                                  • Image-Guided Biopsy

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Jiang T et al: Magnetic resonance imaging features of breast encapsulated papillary carcinoma. J Comput Assist Tomogr. 42(4):536-41, 2018
                                                                                          2. Li X et al: Encapsulated papillary carcinoma of the breast: a clinicopathological study of 49 cases. Curr Probl Cancer. 42(3):291-301, 2018
                                                                                          3. Steponavičienė L et al: Diagnosis, treatment, and outcomes of encapsulated papillary carcinoma: a single institution experience. Acta Med Litu. 25(2):66-75, 2018
                                                                                          4. Yee C et al: Early local recurrence in a patient with encapsulated papillary carcinoma of the breast. Clin Breast Cancer. 18(4):e447-8, 2018
                                                                                          5. Rakha EA et al: Papillary carcinoma of the breast: diagnostic agreement and management implications. Histopathology. 69(5):862-70, 2016
                                                                                          6. Tariq N et al: Encapsulated papillary carcinoma (EPC) of breast: a clinical, pathological and immunohistochemical analysis of eight cases. J Pak Med Assoc. 66(11):1490-3, 2016
                                                                                          7. George K et al: Encapsulated papillary carcinoma of the breast: an overview. J Cancer Res Ther. 9(4):564-70, 2013
                                                                                          8. Dhebri AR et al: Intracystic papillary carcinoma of breast: report of three cases and review of the literature. BMJ Case Rep. 2012, 2012
                                                                                          9. Eiada R et al: Papillary lesions of the breast: MRI, ultrasound, and mammographic appearances. AJR Am J Roentgenol. 198(2):264-71, 2012
                                                                                          10. Jakate K et al: Papillary lesions of the breast: impact of breast pathology subspecialization on core biopsy and excision diagnoses. Am J Surg Pathol. 36(4):544-51, 2012
                                                                                          11. Rakha EA et al: Encapsulated papillary carcinoma of the breast: a study of invasion associated markers. J Clin Pathol. 65(8):710-14, 2012
                                                                                          12. Bhargava R et al: Intracystic papillary carcinomas of the breast are more similar to in situ carcinomas than to invasive carcinoma. Am J Surg Pathol. 35(5):778-9; author reply 779-81, 2011
                                                                                          13. Kamyab A et al: Intracystic papillary carcinoma with associated intraductal carcinoma of the breast in a male. Am Surg. 77(12):E267-8, 2011
                                                                                          14. Rakha EA et al: Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. Am J Surg Pathol. 35(8):1093-103, 2011
                                                                                          15. Wynveen CA et al: Intracystic papillary carcinoma of the breast: an in situ or invasive tumor? Results of immunohistochemical analysis and clinical follow-up. Am J Surg Pathol. 35(1):1-14, 2011
                                                                                          16. Linda A et al: Unusual malignant tumors of the breast: MRI features and pathologic correlation. Eur J Radiol. 75(2):178-84, 2010
                                                                                          17. Rodríguez MC et al: Best cases from the AFIP: intracystic papillary carcinoma of the breast. Radiographics. 30(7):2021-7, 2010
                                                                                          18. Yoo JL et al: Can MR imaging contribute in characterizing well-circumscribed breast carcinomas? Radiographics. 30(6):1689-702, 2010
                                                                                          19. Tse GM et al: The role of immunohistochemistry in the differential diagnosis of papillary lesions of the breast. J Clin Pathol. 62(5):407-13, 2009
                                                                                          20. Grabowski J et al: Intracystic papillary carcinoma: a review of 917 cases. Cancer. 113(5):916-20, 2008
                                                                                          21. Collins LC et al: Intracystic papillary carcinomas of the breast: a reevaluation using a panel of myoepithelial cell markers. Am J Surg Pathol. 30(8):1002-7, 2006
                                                                                          22. Mercado CL et al: Papillary lesions of the breast at percutaneous core-needle biopsy. Radiology. 238(3):801-8, 2006
                                                                                          23. Carder PJ et al: Needle core biopsy can reliably distinguish between benign and malignant papillary lesions of the breast. Histopathology. 46(3):320-7, 2005
                                                                                          24. Hill CB et al: Myoepithelial cell staining patterns of papillary breast lesions: from intraductal papillomas to invasive papillary carcinomas. Am J Clin Pathol. 123(1):36-44, 2005
                                                                                          25. Yang WT et al: Sonographic, mammographic, and histopathologic correlation of symptomatic ductal carcinoma in situ. AJR Am J Roentgenol. 182(1):101-10, 2004
                                                                                          26. Liberman L et al: Case 35: intracystic papillary carcinoma with invasion. Radiology. 219(3):781-4, 2001
                                                                                          27. Liberman L et al: Percutaneous large-core biopsy of papillary breast lesions. AJR Am J Roentgenol. 172(2):331-7, 1999
                                                                                          28. McCulloch GL et al: Radiological features of papillary carcinoma of the breast. Clin Radiol. 52(11):865-8, 1997
                                                                                          29. Soo MS et al: Papillary carcinoma of the breast: imaging findings. AJR Am J Roentgenol. 164(2):321-6, 1995
                                                                                          30. Kraus FT et al: The differential diagnosis of papillary tumors of the breast. Cancer. 15:444-55, 1962