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Histopathological and Immunohistochemical Studies of A Typical Case of Intraductal Papillary Carcinoma of A Male Breast

Jaydeep Nath, Simanti Sinha, Abhishek Mukherjee, Tridip Chatterjee

Intraductal papillary carcinoma is very uncommon breast disease, constituting 0.5% to 1% of all breast cancers. Intraductal and intracystic papillary carcinomas are the histological classification of papillary carcinomas. Here we report, a 61 year old man presented with a mass in the upper outer quadrant of the left breast, with associated nipple discharge and bleeding since 2 months. Histological examination revealed tumor cells arranged in multi-cell layered papillae mostly in dilated lumen with foci of cribriform, follicular and solid pattern. Occasional psammoma bodies are also noted. Surgical excision is usually recommended after core-needle biopsy if there is atypia, high risk lesion, imaging histological discordance or positivity for malignancy. Often biopsy excision is performed directly when papillary carcinoma is suggested by sonography or mammography. Indeed, the surgical excision allows the pathologist to classify the papillary by classically histological examination of the lesions especially with immunohistochemical study and to research invasion or DCIS in surrounding breast tissue, present in majority of cases. There are no evidence based guidelines for treatment of intraductal papillary carcinoma. Hence, it is recommended to go for conservative surgery without axillary dissection, which shows excellent prognosis.