Symptoms, risk factors and more

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Papillary breast cancer is a rare type of invasive breast cancer. It is usually slow growing and responds well to treatment.

In this article, we will discuss the characteristics of papillary breast cancer, who gets it, and what you can expect from treatment.

Papillary breast cancer is rare, constituting only 0.5 to 1 percent of all breast cancers. Like many breast cancers, it begins in the milk ducts. However, it tends to contain both invasive cells and non-invasive (in situ) cells.

Under the microscope, a papillary breast tumor appears to have small, finger-like growths called papules. The boundaries are generally well defined. It’s a distinctive look that sets it apart from other breast cancers.

Lymph node involvement is less likely with papillary breast cancer than with other types of breast cancer. Papillary breast cancer tends to be:

  • small
  • estrogen receptor positive, progesterone receptor positive, or both
  • HER2-negative

A Retrospective study published in 2021 analyzed 44 cases of invasive papillary breast cancer. Of these, 72.7% were positive for estrogen receptors and progesterone receptors, while only 13.6% were HER2 positive.

The symptoms of papillary breast cancer are the same as those of other types of breast cancer. These may include:

  • a lump, thickening, or swelling on the chest or armpits
  • any changes in the size or shape of the breasts
  • nipple discharge
  • nipple pulling inward
  • puckering or padding of the skin
  • redness or peeling of the skin
  • pain

Cancer occurs when there are errors in DNA. As the abnormal breast cells grow and divide, they create more cells with errors. Eventually, these cells start to grow out of control and form a tumor. It is not known what causes a person to develop papillary breast cancer.

Papillary breast cancer is The most common in postmenopausal affected female at birth. However, people assigned to a male at birth and younger women can also get it.

Research suggests that papillary breast cancer is usually diagnosed in people aged 63 to 67. This is not always the case, but some may have a pre-existing papilloma (a type of non-cancerous tumor).

According to American Cancer Society, having a papilloma does not increase the risk of breast cancer unless it has other changes such as atypical hyperplasia. Having multiple papillomas may slightly increase your risk of breast cancer.

Factors that put you at risk

The factors that put you at high risk breast cancers are:

  • family history of breast cancer
  • hereditary genetic changes such as BRCA1 and BRCA2 mutation

Other risk factors for breast cancer include:

  • menstruation before 12 years old
  • menopause after 55 years
  • taking hormonal treatment or certain oral contraceptives
  • sedentary (inactive) lifestyle
  • being overweight and obese after menopause
  • drinking alcohol

Papillary breast cancer is diagnosed the same way as other breast cancers. This may include a:

If a diagnosis cannot be made based on a physical examination and imaging tests, you will need a breast biopsy. This is the only way to rule out or confirm cancer.

In this procedure, the doctor uses a needle to take samples of suspicious tissue. The samples are then sent to a lab, where a pathologist uses a microscope to look for cancer cells.

The pathology report will indicate whether the sample is benign (non-cancerous) or malignant (cancerous). If cancer is found, it will also provide information such as:

Tumor grade describes the appearance and behavior of cells. Grade 1 means the cells look and behave the same as normal breast cells. Grade 3 means the cells are very different from normal cells and are growing aggressively. Papillary breast cancer is often grade 2.

Papillary tumors can be benign or malignant. This makes the diagnosis difficult. During a needle biopsy, the doctor may take several samples of the tumor. These samples may not contain invasive cancer cells.

However, papillary breast cancer can have both invasive and non-invasive cells. Other parts of the tumor may indeed contain invasive cancer cells. According to Johns Hopkins MedicineThis is why surgery to remove a papilloma is generally recommended, even if it is considered benign.

Papillary breast cancer is invasive breast cancer.

Intracanal papillomas are not cancerous. These are benign tumors that develop in the milk ducts, usually near the nipple. These tumors are made up of glandular tissue, fibrous tissue, and blood vessels. If you have a single tumor like this, it is called a solitary intracanal papilloma.

Sometimes a cluster of benign papillomas develop in small ducts farther from the nipple. In this case, they are called multiple papillomas.

Papillomatosis in a condition where you have tiny, less distinct areas of cell growth in the ducts.

Treatment for papillary breast cancer depends on the specific characteristics of the cancer. Here are the:

  • estrogen and progesterone receptor status
  • HER2 status
  • tumor size
  • tumor grade

Surgery

In most cases, you will need surgery to remove the tumor. Breast-conserving surgery, also known as lumpectomy, involves removing the tumor, along with a small margin of healthy tissue around it. A mastectomy involves removing the entire breast.

You also have the option of having reconstructive surgery.

Radiotherapy

Radiation therapy usually follows breast-conserving surgery and may also follow a mastectomy. This can help destroy any remaining cancer cells. Radiation therapy may be directed to the tumor site, chest wall, or lymph nodes.

Chemotherapy

Chemotherapy drugs are used to destroy cancer cells anywhere in the body. This may be recommended if there is a chance that the cancer has spread beyond the primary tumor. This can help reduce the chances of cancer reaching distant sites or recurring.

Hormone therapy

If your tumor is estrogen or progesterone receptor positive, it means the cancer is using hormones for fuel. Hormonal therapies are drugs that help block or stop the effects of these hormones. Hormone therapy is not an option when the tumor is negative for estrogen and progesterone receptors.

Targeted therapies

Targeted therapies are drugs that target a specific characteristic of cancer. Some breast cancers use a protein called HER2 to stimulate growth. Most papillary breast cancers are HER2-negative. If your breast cancer tests HER2-positive, your treatment plan may include anti-HER2 therapy.

This type of cancer generally responds well to treatment and the outlook is good.

According to National Cancer Institute, the 5-year relative survival rates for breast cancer are:

  • localized: 99 percent
  • regional breakdown: 85.8%
  • distance spread: 29%

These data are based on women diagnosed from 2011 to 2017.

Papillary breast cancer rarely metastasis (spreads to other parts of the body) and has better overall survival and a better prognosis than other breast cancers. Your individual perspective depends on many factors, such as:

  • stage at diagnosis
  • tumor grade
  • age and general health
  • estrogen and progesterone receptor status
  • HER2 status

Your oncologist can discuss how your risk factors and treatment options may affect your outlook.


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