gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Atypical papilloma of the breast are at high risk for invasive carcinoma

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker Nik Hauser - Universitäts-Frauenklinik Ulm, Deutschland
  • Rolf Kreienberg - Universitäts-Frauenklinik Ulm
  • Volker Heilmann - Universitäts-Frauenklinik Ulm

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO020

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Veröffentlicht: 20. März 2006

© 2006 Hauser et al.
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The diagnosis of an atypical papilloma of the breast, classified histopathologically as a suspicious papillary lesion or a borderline lesion, respectively needs further diagnostic evaluation. The classification of papillary lesions of the breast is based on pathologic and immunohistochemic findings. We distinguish benign intraductal papilloma from papillary carcinoma. Atypical papilloma are non classifiable lesions, determined as suspicious papillary lesions or borderline lesions, respectively. The proof of the presence of myoepithelial cells is decisive to distinguish benign from malign papillary lesions of the breast. The entire classification of papilloma shows up with 20% of the lesions as simple ductal hyperplasia, in 35% focal atypia is present, 20% have to be classified as atypical papilloma, whereas in 25% of all cases invasive carcinoma developing within the papilloma can be demonstrated. Patients with the diagnosis of an atypical papilloma are at high risk for hidden carcinoma in situ or even invasive carcinoma. We demonstrate as an example the case of a patient with a papillary tumour of the breast relapsing four months after resection of the cystic structure. Only after wide excision changes from an atypical intraductal papilloma to a carcinoma in situ and focally to an invasive carcinoma could be found. If a papillary lesion with atypical ductal hyperplasia is histopathologically diagnosed by needle core biopsy, a ductal carcinoma in situ can be demonstrated in 30% after complete resection of the lesion. If ductal carcinoma in situ within a papilloma is present in the needle core biopsy already, invasive carcinoma is found in 50% of all cases in the histologic preparation after complete resection. These findings justify invasive therapy by complete resection of all atypical papilloma of the breast. Interdisciplinary collaboration of gynecologists, radiologists and pathologists is essential to indicate operative therapies after careful histologic description of epithelial changes within papillary lesions from normal to hyperplasia and atypia.