Abstract

In this report, we make a review of the literature on the intraductal intracystic papillary carcinoma of the breast and evaluate the frequency of these cases presenting in our clinic from l982 to l995. Because this is an uncommon disease, we report the two cases recently diagnosed, treated and followed by our clinic. In order to make this disease better known, we review its macro and microscopic characteristics, the methods used for its diagnoses as well as aspects related to its prognosis and treatment.

The intracystic pappilary carcinoma is a breast carcinoma that grows under a papillary form inside cysts. It is a subtype of a recently recognized carcinoma, that has the structure of the papilloma with epithelium, which has enough distinctive characteristics for a diagnosis of in situ carcinoma. Its structure is clearly papillar and its cell aspect is obviosly malign (1). The diagnosis will be established through fine needle aspiration, pneumocistography, flow citometry, immunohistochemistry and others.

The differential diagnosis is made with the colloid carcinoma and with the medullary carcinoma, on mammography, and with the benign solitary intraductal papilloma and multiple intraductal papilloma, on histology.

The prognosis for intracistic papillar carcinoma is excellent , except for the lesions with a greater degree of nuclear atipia.

Therapy includes surgical procedures, which may vary from tumorectomy up to total mastectomy, with or without axillary dissection, radiotherapy and chemotherapy, according to each particular case. In two cases described in this paper, we approach the different modalities of treatment used. The intracistic papillar carcinoma is a rare tumor, and therapeutics should be based on its biological behavior and histogenetic origins, thus it should be highlighted the importance of publishing case report papers.

Key words: breast carcinoma; intracystic papillary carcinoma; pathology; diagnostic; prognostic; treatment.