Approach to Papillary Lesions of the Breast (a Report of Three Cases)

Introduction: Papillary lesions of the breast contain a great spectrum of lesions extending from benign papillomas to frankly invasive papillary carcinomas. There are different classifications and terminologies, and most cases have coexisting lesions resulting in difficulty both in diagnosis and management. We aim to review papillary lesions of the breast by presenting three cases with different lesions. Cases: We present here an in situ papillary carcinoma, an intracystic papillary carcinoma and an invasive papillary carcinoma, all with coexisting pathologies in the surrounding tissues. Patients had to have mastectomy in all cases with evaluation of axilla either by sentinel lymph node biopsy or by axillary dissection. No metastasis was detected in axillary nodes in either case. Discussion: All papillary lesions should be excised, although benign on needle biopsy, because there may be atypia, or in situ or invasive foci around the main lesion the needle targeted. Most have an excellent prognosis if removed with an adequate free surgical margin because recurrences are usually due to skipped in situ or invasive lesions in the surrounding tissue. For invasive cases, axillary metastasis is rare, thus sentinel node biopsy has recently provided avoidance from unnecessary axillary dissection.