Abstract
Introduction
The significance of absence of myoepithelial cells in circumscribed papillary breast
lesions is controversial. When the DCIS with papillary architecture is associated
with adjacent conventional invasive carcinoma, the size and stage of the carcinoma
could vary substantially depending on whether the intraductal papillary component
lacking a periductal ME cell layer is interpreted as invasive or intraepithelial/in
situ.
Design
In a retrospective search of the pathology database at our institution for papillary
DCIS (PDCIS), solid papillary carcinoma (SPC), and encapsulated papillary carcinoma
(EPC) from 2001 to 2014, 73 lesions (42 PDCIS, 19 SPC, 12 EPC) with and without associated
invasive carcinoma were identified and reviewed. Forty-five lesions (22 PDCIS, 14
SPC, and 9 EPC) were associated with invasive carcinoma.
Results
Majority of PDCISs (37 of 42) demonstrated retained myoepithelial cells around periphery
of the ducts. Three cases showed discontinuous staining and 2 cases showed absent
myoepithelial cells in the periphery of the ducts. No lymph node metastases were seen
in DCIS in the absence of histologic evidence of invasion regardless of absence of
ME cells around foci of DCIS. With a median follow-up period of 107 months, six distant
metastases occurred, all in patients with invasive carcinoma.
Conclusions
The absence of ME cells around ducts harboring the PDCIS, SPC, or EPC is not indicative
of an invasive process. The prudent use of morphologic criteria is critical to avoid
overstaging and overtreatment.
Keywords
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Article info
Publication history
Published online: September 27, 2022
Accepted:
September 21,
2022
Received in revised form:
September 20,
2022
Received:
June 24,
2022
Identification
Copyright
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