33 Special Types of Invasive Breast Carcinoma: Diagnostic Criteria ...

Grabowski et al. Cancer 2008
• 917 IPC cases (California Tumor Registry), 47% only “CIS”.
• 53% had invasion.
• 90% of invasive cases localized.
• At 10 yrs, pts with “CIS” & invasive disease had same survival
(96.8% ( and 94.4%; ; P = 0.18). )
• No significant difference in long-term survival of pts in the 2
subgroups of IPC.
• Thus, excellent prognosis for IPC whether diagnosed as in situ or
invasive.
• The usual absence of axillary involvement and low recurrence rate
after local excision suggests that wide local excision without axillary
dissection is currently the treatment of choice for pure IPC.
IPC in Males
• Up to 7.5% of all breast cancers in males.
• Presentation & pathology same as females.
• Japanese men, mean age in males is 68 yrs.
• Regardless g of in situ or invasive status, , excellent
prognosis with adequate local therapy alone.
• Thus, manage pts with IPCs as currently
managed (i.e., like pts with DCIS) and avoid
categorization of such lesions as frankly invasive
papillary carcinomas.
Collins et al. AJSP 2006
• Studied 22 IPCs.
• 15 benign intraductal papillomas.
• IHC for 5 MEC markers.
• Smooth muscle myosin heavy chain, calponin, p63,
CD10, & cytokeratin 5/6.
• All IPCs showed complete absence of MEC
• MEC layer detected around DCIS adjacent to IPC.
• Intraductal papillomas showed a MEC layer.
• Possibly, MEC layer attenuated by compression or
encapsulated nodules of invasive papillary carcinoma.
• Authors favored "encapsulated papillary carcinoma
(EPC)" over "intracystic papillary carcinoma"
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