Interesting Breast Tumours: A Tripod of Cases

Main Article Content

Guddi Rani Singh https://orcid.org/0000-0001-8547-1212
Mamta Kumari https://orcid.org/0000-0002-2968-9003
Kumari Sunny
Debaditya Haldar https://orcid.org/0009-0007-5685-3554
Manish Kumar
Rajnikant Prasad

Keywords

Breast Cancer, solid papillary carcinoma, invasive papillary carcinoma, glycogen rich clear cell carcinoma

Abstract

Knowledge regarding the lesser common breast tumours, including malignant papillary neoplasms and glycogen rich clear cell carcinoma, is limited. Overall, cases of papillary carcinoma of breast fare better than invasive breast carcinoma, from the data available in literature. Glycogen rich clear cell carcinoma is characterized by the presence of clear cells, having mostly a poorer prognosis. We hereby present three such cases which would add to the existing available information.


Case 1 is a 79-year-old female who presented with a left breast lump and bloody nipple discharge. Mammography suggested malignant lesion, with FNAC suspicious of malignancy. Surgery was done and histopathological examination showed irregular islands of tumour cells having papillary fronds with absence of myoepithelial layer. Immunohistochemically, the tumour was GATA3, CK7, ER, PR positive, HER2 negative, and having Ki67 index 10%. The case was diagnosed as Solid papillary carcinoma.


Case 2 is a 57-year-old female presenting with a left breast lump along with bloody nipple discharge. Mammography and FNAC were in favour of malignancy. Trucut biopsy was done, microscopy revealing a tumour having >90% papillary architecture with infiltrative pattern. Features were suggestive of Invasive breast carcinoma with papillaroid features. The tumour was GATA3, CK7, ER, PR positive, HER2 negative, and Ki67 index was 15%.


Case 3 is a 70-year-old female presenting with a right breast lump with nipple retraction. Mammography and FNAC were suggestive of malignancy. Trucut biopsy followed by microscopy revealed polygonal tumour cells with clear cytoplasm in nested pattern, showing positive staining for Periodic Acid Schiff. Immunostaining showed GATA3 positive, PAX8 negative, ER and PR positive, HER2 negative, and Ki67 index 20%. A diagnosis of Invasive breast carcinoma with Glycogen-rich clear cell pattern was made.


Identifying these rare entities is important along with assessing hormone status for avoiding overtreatment and undertreatment, and applying appropriate targeted therapies.


 

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References

1. Ingale YP, Buch AC, Jose M, Bavikar RR. Invasive papillary carcinoma of the breast - A rare case report. Medical Journal of Dr. DY Patil University. 2022 Sep 1;15(5):782-4.

2. Hashmi AA, Munawar S, Rehman N, Ahmed O, Islam S, Asghar IA, et al. Invasive papillary carcinoma of the breast: clinicopathological features and hormone receptor profile. Cureus. 2021 Feb 22;13(2):e13480. doi: 10.7759/cureus.13480.

3. Yerushalmi R, Hayes MM, Gelmon KA. Breast carcinoma - rare types: a review of the literature. Annals of oncology. 2009 Nov 1;20(11):1763-70.

4. Morgan S, Dodington D, Wu JM, Turashvili G. Solid papillary carcinoma and encapsulated papillary carcinoma of the breast: clinical-pathologic features and basement membrane studies of 50 cases. Pathobiology. 2021;88(5):359-73.

5. Jadhav T, Prasad SS, Guleria B, Tevatia MS, Guleria P. Solid papillary carcinoma of the breast. Autopsy and Case Reports. 2022 Jan 17;12. e2021352. doi: 10.4322/acr.2021.352.

6. Tay TK, Tan PH. Papillary neoplasms of the breast—reviewing the spectrum. Modern Pathology. 2021 Jun 1;34(6):1044-61.

7. Hashmi AA, Iftikhar SN, Haider R, Haider R, Irfan M, Ali J. Solid papillary carcinoma of breast: clinicopathologic comparison with conventional ductal carcinoma of breast. Cureus. 2020 Oct 26;12(10):e11172. doi: 10.7759/cureus.11172.

8. Rehman B, Mumtaz A, Sajjad B, Urooj N, Khan SM, Zahid MT et al. Papillary Carcinoma of Breast: Clinicopathological Characteristics, Management, and Survival. International Journal of Breast Cancer. 2022 Oct 13;2022.

9. Kulka J, Madaras L, Floris G, Lax SF. Papillary lesions of the breast. Virchows Archiv. 2022 Jan 1:1-20.

10. Zheng YZ, Hu X, Shao ZM. Clinicopathological characteristics and survival outcomes in invasive papillary carcinoma of the breast: a SEER population-based study. Scientific reports. 2016 Apr 7;6(1):24037.

11. Pal SK, Lau SK, Kruper L, Nwoye U, Garberoglio C, Gupta RK et al. Papillary carcinoma of the breast: an overview. Breast cancer research and treatment. 2010 Aug; 122:637-45.

12. Rakha EA, Allison KH, Ellis IO, Horii R, Masuda S, Penault-Llorca F et al. Invasive breast carcinoma of no special type. In: WHO Classification of Tumours Editorial Board. Breast tumours. Lyon (France): International Agency for Research on Cancer; 2019. (WHO
classification of tumours series, 5th ed.; vol. 2).

13. Moyer AB, Duhon DJ, Schwartz MR, Ro JY, Miller RA. Clear cell hidradenoma in a patient with previous glycogen rich clear cell carcinoma of the breast: Diagnostic pitfalls and pearls. Human Pathology: Case Reports. 2018 Jun 1; 12:32-5.

14. Zhou Z, Kinslow CJ, Hibshoosh H, Guo H, Cheng SK, He C et al. Clinical features, survival, and prognostic factors of glycogen-rich clear cell carcinoma (GRCC) of the breast in the US population. Journal of clinical medicine. 2019 Feb 14;8(2):246.

15. Ratti V, Pagani O. Clear cell carcinoma of the breast: a rare breast cancer subtype-case report and literature review. Case Reports in Oncology. 2015 Dec 1;8(3):472-7.

16. Georgescu TA, Munteanu O, Lisievici AC, Tebeică T, Crețoiu D, Toader O et al. Glycogen-rich clear cell carcinoma of the breast with solid papillary pattern: Two cases with heterogeneous clinicopathological features. Experimental and Therapeutic Medicine. 2021 May 1;21(5):1-6.

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