What is Papillary Breast Cancer & How is it Treated? | Causes, Symptoms, Outlook and Risk Factors of Papillary Breast Cancer

What is Papillary Breast Cancer?

Papillary breast cancer, also known as intraductal papillary duct carcinoma, is a rare type of breast carcinoma. It accounts for 0.5 % of all breast cancer cases(1). Papillary breast cancer starts in the milk ducts and contains both invasive and non-invasive cells. Papillary breast cancer is seen as a finger-like projection when the cells are examined under a microscope. In papillary breast cancer, lymph node involvement is less likely than is mostly observed in other types of breast cancers.

Causes of Papillary Breast Cancer

The growth of cancer cells takes place due to abnormal DNA. The abnormal cells grow and divide and create more cells with errors. The cells then start growing out of control and form tumors.

The exact cause responsible for the occurrence of papillary breast cancer is unknown.

Papillary breast cancer is known to be common in postmenopausal women(1). It is typically diagnosed in people 63-67 years of age(2). However, younger females can get it too.

Having one papilloma does not increase the risk of breast cancer.

Risk Associated with Papillary Breast Cancer

Factors that put a person at risk of breast cancer are:

  • Strong family history of breast cancer
  • BRCA1 and BRCA2 mutations
  • Menstruation before age of 12
  • Menopause after 55 years
  • Taking hormonal therapy
  • Those with a sedentary lifestyle
  • Drinking alcohol
  • Taking oral contraceptive

Symptoms of Papillary Breast Cancer

The symptoms of papillary breast cancer are similar to those of other types of breast cancers, which include:

  • Presence of lump, thickening, or swelling under the breast or underarm.
  • Discharge from the nipple
  • Pain
  • Change in breast size and shape
  • Inward pulling of the nipple
  • Dimpling of the skin
  • Redness and flaking of the skin

Diagnosis of Papillary Breast Cancer

A few diagnostic techniques used for papillary breast cancer are:

A biopsy is done if the above tests are not helping with the diagnosis. This can be a way to confirm or rule out cancer.

For the biopsy, a sample is taken from the suspicious tissue and sent to the laboratory to be checked by a pathologist.

A pathology report states whether the sample is benign or malignant. If the report states cancer, it also provides the information about:

  • Estrogen and progesterone receptor
  • GER2 status
  • Tumor grade

Sometimes papillary breast cancers are misdiagnosed as intraductal papilloma or papillomatosis.

Intraductal papilloma are the non-cancerous conditions. It is a puncture made by a tiny wart-like growth in the breast tissue. Intraductal papilloma grows inside the milk duct. They may lead to benign nipple discharge.

Papillomatosis is a condition that is noncancerous and in which the cells start growing larger and faster than normal.

Treatment of Papillary Breast Cancer

The treatment of Papillary Breast Cancer depends on the specific features of cancer, such as:

  • Tumor size
  • Tumor grade
  • HER2 status
  • Estrogen and progesterone receptor status

1. Surgery

In most cases, surgery is done to get rid of the tumor. The surgical procedures to treat Papillary Breast Cancer are:

Lumpectomy: A procedure when the surgeon removes the lump and some of the healthy breast tissue from around.

Mastectomy: It is a procedure that involves the removal of the entire breast.

2. Radiation Therapy

Radiation therapy usually follows breast-conserving surgery or may even be given after mastectomy. This can help in destroying the remaining cancer cells. Radiation therapy is directed towards the site of the tumor, chest wall, or lymph nodes.

3. Chemotherapy

Chemotherapy for papillary breast cancer is done to destroy cancer cells anywhere in the body.

It is given in the cases when the cancer cells have spread beyond the primary tumor and reduce the chances of cancer reaching distant sites.

4. Hormone Therapy

If the tumor is estrogen-progesterone positive, hormone therapy helps in blocking or stopping the effect of these hormones. It is used in cases when cancer is using hormones as fuel. It cannot be used when the tumor is estrogen-progesterone negative.

5. Targeted Therapies

Targeted therapies are used to target a specific feature of cancer. For example, Anti-HER2 therapy is used for cancers that are HER2-positive.

Outlook of Papillary Breast Cancer

Papillary breast cancers have a positive outlook. They rarely metastasize and have better overall survival and prognosis than other breast cancers.

The individual outlook depends on:

  • Stage of diagnosis
  • Age and overall health
  • Tumor grade
  • HER2 status
  • Estrogen and progesterone receptor status

The oncologist can discuss the risk factors and treatment options.

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