Papillary Lesions of the Male Breast.
Radenka Bozanovic, Alyce Lytwyn, Ala Samkari, Kavita Dhamanaskar, Leela Elavathil. McMaster University, Hamilton, ON, Canada
Background: The majority of breast cancers occur in women. However, the papillary variants of both in situ and invasive carcinomas are more frequent in men. The literature regarding the spectrum of papillary lesions in men is limited, consisting of case reports and only few case series. We report the papillary lesions in men encountered in our institution, and classify them according to recently published criteria (Collins et al.2008).
Design: We searched the our institutional computerized pathology database for male papillary breast lesions for the period from January 1990 to May 2010. Clinical histories and radiological imaging were reviewed. All pathology reports and H&E slides as well as immunohistochemical stains to evaluate for presence of myoepithelial cells are reviewed. Diagnoses were reclassified according to recently published reviews.
Results: Fifteen cases are identified. The age of patients ranged form 38 to 85 (median 62) years. They all presented with a retroareolar palpable mass. Four patients also had nipple discharge. Duration of symptoms varied from 2 weeks up to 12 years. Gynecomastia was present in 4 cases. Three patients had positive family history for breast cancer; of these, 2 had BRCA 1 / BRCA 2 genetic testing and both were normal. Pathology review showed 6 intracystic papillary carcinomas (IPC), 4 IPC with invasive ductal carcinoma arising from IPC and invading into adjacent breast tissue, 1 papillary ductal carcinoma in situ (DCIS), 2 papilloma with superimposed DCIS, 1 papilloma with superimposed ADH, and 1 benign papilloma with apocrine changes. The papillary lesions ranged in size from 0.7 cm to 3.8 cm (median 2.1 cm). The invasive carcinomas ranged in size from less than 0.1 cm to 1.9 cm (median 0.5 cm). Immunohistochemistry for estrogen and progesterone receptors were performed in 12 cases and all showed positivity for both receptors. Four patients underwent lumpectomy and 11 mastectomy. One of 7 patients with axillary node sampling showed axillary metastatic spread.
Conclusions: In our study the papillary lesions in the male breast consisted predominantly of intracystic papillary carcinoma. As in the female breast, we encountered a similar spectrum of papillary lesions ranging from benign papillomas to in situ papillary carcinomas with invasion.
Monday, February 28, 2011 1:00 PM
Poster Session II # 50, Monday Afternoon