Invasive Papillary Carcinoma

Invasive Papillary Carcinoma

This invasive carcinoma consists of poorly circumscribed nests of cells with papillary and cribriform patterns. Fibrovascular cores image are present within the carcinoma.

Immunohistochemical study for cytokeratin (red cytoplasmic positivity) and p63 demonstrates the complete absence of myoepithelial cells in the carcinoma, including the papillary cores image.



  • Invasive papillary carcinoma (IPC)


  • Invasive carcinomas consisting predominantly of papillae with fibrovascular cores

    • “Papillary carcinoma” includes invasive papillary carcinoma, encapsulated papillary carcinoma, solid papillary carcinoma, papillary carcinoma in situ, and DCIS involving papilloma

    • These lesions are sometimes grouped together

    • Invasive papillary carcinoma is important to identify as risk of lymph node and distant metastases is higher than for other diagnoses



  • Incidence

    • < 2% of breast carcinomas

  • Age

    • More common in postmenopausal women (typically 65-70 years of age)


  • Outcome is generally better than for invasive carcinomas of no special type

    • Papillary carcinomas are generally ER positive and only rarely poorly differentiated

  • Lymph node metastases are present in about 1/3 of cases


Gross Appearance

  • IPC generally has appearance similar to cancers of no special type in having an irregular border


Histologic Features

  • Should have prominent pattern of papillae with fibrovascular cores

    • Papillae lack myoepithelial cells

    • IHC for muscle markers may be difficult to interpret as blood vessels may closely approximate basal portions of cells in fibrovascular cores

    • p63 is generally easier to interpret as blood vessels will be negative

    • Occasional tumor cells may be positive for p63

  • Fibrovascular cores are thin and delicate

  • Cells are monomorphic in appearance and columnar in shape

  • Nuclear grade is generally low or intermediate

  • Mitoses are usually infrequent

  • DCIS of papillary type may be associated with carcinoma



  • Estrogen and progesterone receptors

    • Majority of invasive papillary carcinomas are positive for hormone receptors

  • HER2

    • Only rare papillary carcinomas overexpress HER2

Jul 6, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Invasive Papillary Carcinoma

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