Papillary lesions of the breast - review and practical issues

Semin Diagn Pathol. 2022 Sep;39(5):344-354. doi: 10.1053/j.semdp.2022.06.001. Epub 2022 Jun 11.


Papillary lesions of the breast represent a heterogeneous group of neoplasm featuring fibrovascular cores covered by epithelial cells with or without intervening myoepithelial cells. According to the World Health Organization classification of breast tumors, papillary lesions of the breast are further classified into intraductal papilloma (including intraductal papilloma with atypical ductal hyperplasia /ductal carcinoma in situ), papillary ductal carcinoma in situ, encapsulated papillary carcinoma, solid papillary carcinoma (in situ and invasive) and invasive papillary carcinoma. The overlapping morphological features and immunohistochemical profiles make accurate diagnosis of breast papillary lesion a challenge for pathologists. In this review, the morphological and relevant immunohistochemical features of papillary lesions are discussed, with further emphasis on some commonly encountered practical diagnostic issues. A simple diagnostic algorithm will be established. The relevant molecular characteristics will be discussed as well.

Keywords: Breast; Encapsulated papillary carcinoma; Intraductal papilloma; Invasive papillary carcinoma; Papillary lesion; Solid papillary carcinoma.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma, Papillary* / pathology
  • Breast / pathology
  • Breast Neoplasms* / pathology
  • Carcinoma, Intraductal, Noninfiltrating* / diagnosis
  • Carcinoma, Intraductal, Noninfiltrating* / pathology
  • Carcinoma, Papillary* / diagnosis
  • Carcinoma, Papillary* / pathology
  • Female
  • Humans
  • Papilloma, Intraductal* / diagnosis
  • Papilloma, Intraductal* / pathology