Top

Published in:

01-01-2022 | Fibromatosis | Review

Breast carcinomas of low malignant potential

Authors: Stuart J. Schnitt, Falko Fend, Thomas Decker

Published in: Virchows Archiv | Issue 1/2022

Abstract

Some breast carcinomas have a very low likelihood of metastasis to regional lymph nodes and distant sites and may be considered carcinomas of low malignant potential. In this article, we review the clinical, pathologic, immunophenotypic, and molecular features of selected breast carcinomas of low malignant potential including low-grade adenosquamous carcinoma, fibromatosis-like metaplastic carcinoma, encapsulated papillary carcinoma, solid papillary carcinoma, and tall cell carcinoma with reversed polarity.

Available only for authorised users

Drudis T, Arroyo C, Van Hoeven K, Cordon-Cardo C, Rosen PP (1994) The pathology of low-grade adenosquamous carcinoma of the breast. An immunohistochemical study. Pathol Annu 29(Pt):181–97PubMed

Rosen PP, Ernsberger D (1987) Low-grade adenosquamous carcinoma. A variant of metaplastic mammary carcinoma. Am J Surg Pathol 11(5):351–8PubMedCrossRef

Van Hoeven KH, Drudis T, Cranor ML, Erlandson RA, Rosen PP (1993) Low-grade adenosquamous carcinoma of the breast. A clinocopathologic study of 32 cases with ultrastructural analysis. Am J Surg Pathol 17(3):248–58PubMedCrossRef

Soo K, Tan PH (2013) Low-grade adenosquamous carcinoma of the breast. J Clin Pathol 66(6):506–511PubMedCrossRef

Foschini MP, Pizzicannella G, Peterse JL, Eusebi V (1995) Adenomyoepithelioma of the breast associated with low-grade adenosquamous and sarcomatoid carcinomas. Virchows Arch 427(3):243–250PubMedCrossRef

Kawaguchi K, Shin SJ (2012) Immunohistochemical staining characteristics of low-grade adenosquamous carcinoma of the breast. Am J Surg Pathol 36(7):1009–1020PubMedCrossRef

Chuthapisith S, Warnnissorn M, Amornpinyokiat N, Pradniwat K, Angsusinha T (2013) Metaplastic carcinoma of the breast with transformation from adenosquamous carcinoma to osteosarcomatoid and spindle cell morphology. Oncol Lett 6(3):728–732PubMedPubMedCentralCrossRef

Wilsher MJ (2014) Adenosquamous proliferation of the breast and low grade adenosquamous carcinoma: a common precursor of an uncommon cancer? Pathology 46(5):402–410PubMedCrossRef

Geyer FC, Lambros MB, Natrajan R, Mehta R, Mackay A, Savage K et al (2010) Genomic and immunohistochemical analysis of adenosquamous carcinoma of the breast. Mod Pathol 23(7):951–960PubMedCrossRef

10.

Bataillon G, Collet JF, Voillemot N, Menet E, Vincent-Salomon A, Klijanienko J (2014) Fine-needle aspiration of low-grade adenosquamous carcinomas of the breast: a report of three new cases. Acta Cytol 58(5):427–431PubMedCrossRef

11.

Boecker W, Stenman G, Loening T, Andersson MK, Berg T, Lange A et al (2015) Squamous/epidermoid differentiation in normal breast and salivary gland tissues and their corresponding tumors originate from p63/K5/14-positive progenitor cells. Virchows Arch 466(1):21–36PubMedCrossRef

12.

Ferrara G, Nappi O, Wick MR (1999) Fine-needle aspiration cytology and immunohistology of low-grade adenosquamous carcinoma of the breast. Diagn Cytopathol 20(1):13–18PubMedCrossRef

13.

Ho BC, Tan HW, Lee VK, Tan PH (2006) Preoperative and intraoperative diagnosis of low-grade adenosquamous carcinoma of the breast: potential diagnostic pitfalls. Histopathology 49(6):603–611PubMedCrossRef

14.

Reis-Filho JS, Gobbi H, McCart Reed AE, Rakha E, Shin SJ, Sotiriou C, Vincent-Salomon A. Metaplastic carcinoma. In: WHO classification of tumors editorial board, editor. WHO Classification of Tumours: Breast Tumours. Lyon: IARC Press; 2019. p. 134–8.

15.

Scali EP, Ali RH, Hayes M, Tyldesley S, Hassell P (2013) Low-grade adenosquamous carcinoma of the breast: imaging and histopathologic characteristics of this rare disease. Can Assoc Radiol J 64(4):339–344PubMedCrossRef

16.

Gobbi H, Simpson JF, Borowsky A, Jensen RA, Page DL (1999) Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. Cancer 85(10):2170–2182PubMedCrossRef

17.

Sneige N, Yaziji H, Mandavilli SR, Perez ER, Ordonez NG, Gown AM et al (2001) Low-grade (fibromatosis-like) spindle cell carcinoma of the breast. Am J Surg Pathol 25(8):1009–1016PubMedCrossRef

18.

Schafernak KT, Policarpio-Nicolas ML, Wiley EL, Laskin WB, Diaz LK (2006) A 59-year-old woman with a spindle cell lesion of the breast. Low-grade (fibromatosis-like) spindle cell carcinoma of the breast. Arch Pathol Lab Med 130(5):e81-3PubMedCrossRef

19.

Rekhi B, Shet TM, Badwe RA, Chinoy RF (2007) Fibromatosis-like carcinoma-an unusual phenotype of a metaplastic breast tumor associated with a micropapilloma. World J Surg Oncol 5:24PubMedPubMedCentralCrossRef

20.

Podetta M, D’Ambrosio G, Ferrari A, Sgarella A, Dal Bello B, Fossati GS et al (2009) Low-grade fibromatosis-like spindle cell metaplastic carcinoma: a basal-like tumor with a favorable clinical outcome. Report of two cases Tumori 95(2):264–267PubMed

21.

Lamovec J, Gasljevic G (2010) Keloid type of fibromatosis-like metaplastic carcinoma of the breast with transformation into biphasic tumour in recurrences and lymph node metastases. Histopathology 57(2):318–320PubMedCrossRef

22.

Nonnis R, Paliogiannis P, Giangrande D, Marras V, Trignano M (2012) Low-grade fibromatosis-like spindle cell metaplastic carcinoma of the breast: a case report and literature review. Clin Breast Cancer 12(2):147–150PubMedCrossRef

23.

Rito M, Schmitt F, Pinto AE, Andre S (2014) Fibromatosis-like metaplastic carcinoma of the breast has a claudin-low immunohistochemical phenotype. Virchows Arch 465(2):185–191PubMedCrossRef

24.

Takano EA, Hunter SM, Campbell IG, Fox SB (2015) Low-grade fibromatosis-like spindle cell carcinomas of the breast are molecularly exiguous. J Clin Pathol 68(5):362–367PubMedCrossRef

25.

Pinilla Pagnon I, Perez Mies B, Tulio Martinez M, Pena JL, Roldan Cabanillas AM, Romio de las Hera E, Blazquez Ortiz JM, Sanchez Monforte J, Delgado Moya MA, Rubio Marin D. Metaplastic breast carcinoma “fibromatosis like”, associated with intraductal papilloma. Case report and literature review. Hum Pathol Case Reports. 2017;9:15–8.

26.

Zhu H, Li K, Dong DD, Fu J, Liu DD, Wang L et al (2017) Spindle cell metaplastic carcinoma of breast: a clinicopathological and immunohistochemical analysis. Asia Pac J Clin Oncol 13(2):e72–e78PubMedCrossRef

27.

Zhao Y, Gong X, Li N, Zhu B, Yu D, Jin X (2018) Fibromatosis-like metaplastic carcinoma of breast: a challenge for clinicopathologic diagnosis. Int J Clin Exp Pathol 11(7):3691–3696PubMedPubMedCentral

28.

Takatsuka D, Ogura H, Asano Y, Nakamura A, Koizumi K, Shiiya N et al (2021) A difficult-to-diagnose fibromatosis-like metaplastic carcinoma of the breast: a case report. Surg Case Rep 7(1):16PubMedPubMedCentralCrossRef

29.

Gobbi H, Simpson JF, Jensen RA, Olson SJ, Page DL (2003) Metaplastic spindle cell breast tumors arising within papillomas, complex sclerosing lesions, and nipple adenomas. Mod Pathol 16(9):893–901PubMedCrossRef

30.

Dwyer JB, Clark BZ (2015) Low-grade fibromatosis-like spindle cell carcinoma of the breast. Arch Pathol Lab Med 139(4):552–557PubMedCrossRef

31.

Victoor J, Bourgain C, Vander Borght S, Vanden Bempt I, De Rop C, Floris G (2020) Fibromatosis-like metaplastic carcinoma: a case report and review of the literature. Diagn Pathol 15(1):20PubMedPubMedCentralCrossRef

32.

Rakha EA, Aleskandarany MA, Lee AH, Ellis IO (2016) An approach to the diagnosis of spindle cell lesions of the breast. Histopathology 68(1):33–44PubMedCrossRef

33.

Al-Nafussi A (1999) Spindle cell tumours of the breast: practical approach to diagnosis. Histopathology 35(1):1–13PubMedCrossRef

34.

Behranwala KA, Nasiri N, A’Hern R, Gui GP (2004) Clinical presentation and long-term outcome of pure myoepithelial carcinoma of the breast. Eur J Surg Oncol 30(4):357–361PubMedCrossRef

35.

Lefkowitz M, Lefkowitz W, Wargotz ES (1994) Intraductal (intracystic) papillary carcinoma of the breast and its variants: a clinicopathological study of 77 cases. Hum Pathol 25(8):802–809PubMedCrossRef

36.

Collins LC, Carlo VP, Hwang H, Barry TS, Gown AM, Schnitt SJ (2006) Intracystic papillary carcinomas of the breast: a reevaluation using a panel of myoepithelial cell markers. Am J Surg Pathol 30(8):1002–1007PubMedCrossRef

37.

Mulligan AM, O’Malley FP (2007) Papillary lesions of the breast: a review. Adv Anat Pathol 14(2):108–119PubMedCrossRef

38.

Rakha EA, Gandhi N, Climent F, van Deurzen CH, Haider SA, Dunk L et al (2011) Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. Am J Surg Pathol 35(8):1093–1103PubMedCrossRef

39.

Ni YB, Tse GM (2016) Pathological criteria and practical issues in papillary lesions of the breast - a review. Histopathology 68(1):22–32PubMedCrossRef

40.

MacGrogan G, Collins L, Lerwill M, Rakha EA, Tan BY. Encapsulated papillary carcinoma. In: WHO classification of tumors editorial board, editor. WHO Classification of Tumours: Breast Tumours. 5th ed. Lyon: IARC Press; 2019. p. 60–2.

41.

Tay TKY, Tan PH. Papillary neoplasms of the breast-reviewing the spectrum. Mod Pathol. 2021.

42.

Zhong E, Cheng E, Goldfischer M, Hoda SA (2020) Papillary lesions of the male breast: a study of 117 cases and brief review of the literature demonstrate a broad clinicopathologic spectrum. Am J Surg Pathol 44(1):68–76PubMedCrossRef

43.

Collins LC, Schnitt SJ (2008) Papillary lesions of the breast: selected diagnostic and management issues. Histopathology 52(1):20–29PubMedCrossRef

44.

Seal M, Wilson C, Naus GJ, Chia S, Bainbridge TC, Hayes MM (2009) Encapsulated apocrine papillary carcinoma of the breast–a tumour of uncertain malignant potential: report of five cases. Virchows Arch 455(6):477–483PubMedCrossRef

45.

Wynveen CA, Nehhozina T, Akram M, Hassan M, Norton L, Van Zee KJ, et al. Intracystic papillary carcinoma of the breast: an in situ or invasive tumor? Results of immunohistochemical analysis and clinical follow-up. Am J Surg Pathol. 2011.

46.

Duprez R, Wilkerson PM, Lacroix-Triki M, Lambros MB, Mackay A, Hern RA et al (2012) Immunophenotypic and genomic characterization of papillary carcinomas of the breast. J Pathol 226(3):427–441PubMedCrossRef

47.

Piscuoglio S, Ng CK, Martelotto LG, Eberle CA, Cowell CF, Natrajan R et al (2014) Integrative genomic and transcriptomic characterization of papillary carcinomas of the breast. Mol Oncol 8(8):1588–1602PubMedPubMedCentralCrossRef

48.

Rakha EA, Varga Z, Elsheik S, Ellis IO (2015) High-grade encapsulated papillary carcinoma of the breast: an under-recognized entity. Histopathology 66(5):740–746PubMedCrossRef

49.

Mulligan AM, O’Malley FP (2007) Metastatic potential of encapsulated (intracystic) papillary carcinoma of the breast: a report of 2 cases with axillary lymph node micrometastases. Int J Surg Pathol 15(2):143–147PubMedCrossRef

50.

MacGrogan G, Collins LC, Lerwill M, Rakha EA, Tan BY. Solid papillary carcinoma (in situ and invasive). In: WHO classification of tumors editorial board, editor. WHO Classification of Tumours: Breast Tumours. 5th ed. Lyon: IARC Press; 2019. p. 63–5.

51.

Maluf HM, Koerner FC. Solid papillary carcinoma of the breast. A form of intraductal carcinoma with endocrine differentiation frequently associated with mucinous carcinoma. Am J Surg Pathol. 1995;19(11):1237–44.

52.

Tan BY, Thike AA, Ellis IO, Tan PH (2016) Clinicopathologic Characteristics of Solid Papillary Carcinoma of the Breast. Am J Surg Pathol 40(10):1334–1342PubMedCrossRef

53.

Nicolas MM, Wu Y, Middleton LP, Gilcrease MZ (2007) Loss of myoepithelium is variable in solid papillary carcinoma of the breast. Histopathology 51(5):657–665PubMedCrossRef

54.

Nassar H, Qureshi H, Volkanadsay N, Visscher D (2006) Clinicopathologic analysis of solid papillary carcinoma of the breast and associated invasive carcinomas. Am J Surg Pathol 30(4):501–507PubMedCrossRef

55.

Otsuki Y, Yamada M, Shimizu S, Suwa K, Yoshida M, Tanioka F et al (2007) Solid-papillary carcinoma of the breast: clinicopathological study of 20 cases. Pathol Int 57(7):421–429PubMedCrossRef

56.

Moritani S, Ichihara S, Kushima R, Okabe H, Bamba M, Kobayashi TK et al (2007) Myoepithelial cells in solid variant of intraductal papillary carcinoma of the breast: a potential diagnostic pitfall and a proposal of an immunohistochemical panel in the differential diagnosis with intraductal papilloma with usual ductal hyperplasia. Virchows Arch 450(5):539–547PubMedCrossRef

57.

Tan PH, Schnitt SJ, van de Vijver MJ, Ellis IO, Lakhani SR (2015) Papillary and neuroendocrine breast lesions: the WHO stance. Histopathology 66(6):761–770PubMedCrossRef

58.

Pareja F, D'Alfonso TM. Neuroendocrine neoplasms of the breast: A review focused on the updated World Health Organization (WHO) 5th Edition morphologic classification. Breast J. 2020;26(6):1160–7.

59.

Chiang S, Weigelt B, Wen HC, Pareja F, Raghavendra A, Martelotto LG et al (2016) IDH2 mutations define a unique subtype of breast cancer with altered nuclear polarity. Cancer Res 76(24):7118–7129PubMedPubMedCentralCrossRef

60.

Bhargava R, Florea AV, Pelmus M, Jones MW, Bonaventura M, Wald A et al (2017) Breast tumor resembling tall cell variant of papillary thyroid carcinoma: a solid papillary neoplasm with characteristic immunohistochemical profile and few recurrent mutations. Am J Clin Pathol 147(4):399–410PubMedCrossRef

61.

Lozada JR, Basili T, Pareja F, Alemar B, Paula ADC, Gularte-Merida R et al (2018) Solid papillary breast carcinomas resembling the tall cell variant of papillary thyroid neoplasms (solid papillary carcinomas with reverse polarity) harbour recurrent mutations affecting IDH2 and PIK3CA: a validation cohort. Histopathology 73(2):339–344PubMedPubMedCentralCrossRef

62.

Alsadoun N, MacGrogan G, Truntzer C, Lacroix-Triki M, Bedgedjian I, Koeb MH et al (2018) Solid papillary carcinoma with reverse polarity of the breast harbors specific morphologic, immunohistochemical and molecular profile in comparison with other benign or malignant papillary lesions of the breast: a comparative study of 9 additional cases. Mod Pathol 31(9):1367–1380PubMedCrossRef

63.

Zhong E, Scognamiglio T, D’Alfonso T, Song W, Tran H, Baek I et al (2019) Breast tumor resembling the tall cell variant of papillary thyroid carcinoma: molecular characterization by next-generation sequencing and histopathological comparison with tall cell papillary carcinoma of thyroid. Int J Surg Pathol 27(2):134–141PubMedCrossRef

64.

Haefliger S, Muenst S, Went P, Bihl M, Dellas S, Weber WP et al (2020) Tall cell carcinoma of the breast with reversed polarity (TCCRP) with mutations in the IDH2 and PIK3CA genes: a case report. Mol Biol Rep 47(6):4917–4921PubMedCrossRef

65.

Jassim M, Premalata CS, Okaly G, Srinivas C. Tall cell carcinoma with reverse polarity of breast: report of a case with unique morphologic and molecular features. Turk Patoloji Derg. 2020.

66.

Guo S, Wang Y, Rohr J, Fan C, Li Q, Li X et al (2016) Solid papillary carcinoma of the breast: a special entity needs to be distinguished from conventional invasive carcinoma avoiding over-treatment. Breast 26:67–72PubMedCrossRef

67.

Yang WT, Bu H, Foschini MP, Schnitt SJ. Tall cell carcinoma with reversed polarity. In: Board WCoTE, editor. WHO Classification of Tumours: Breast Tumours. 5th ed. Lyon: IARC Press; 2019. p. 153–4.

68.

Eusebi V, Damiani S, Ellis IO, Azzopardi JG, Rosai J (2003) Breast tumor resembling the tall cell variant of papillary thyroid carcinoma: report of 5 cases. Am J Surg Pathol 27(8):1114–1118PubMedCrossRef

69.

Foschini MP, Asioli S, Foreid S, Cserni G, Ellis IO, Eusebi V et al (2017) Solid papillary breast carcinomas resembling the tall cell variant of papillary thyroid neoplasms: a unique invasive tumor with indolent behavior. Am J Surg Pathol 41(7):887–895PubMedCrossRef

70.

Pareja F, da Silva EM, Frosina D, Geyer FC, Lozada JR, Basili T et al (2020) Immunohistochemical analysis of IDH2 R172 hotspot mutations in breast papillary neoplasms: applications in the diagnosis of tall cell carcinoma with reverse polarity. Mod Pathol 33(6):1056–1064PubMedPubMedCentralCrossRef

71.

Cameselle-Teijeiro J, Abdulkader I, Barreiro-Morandeira F, Ruiz-Ponte C, Reyes-Santias R, Chavez E et al (2006) Breast tumor resembling the tall cell variant of papillary thyroid carcinoma: a case report. Int J Surg Pathol 14(1):79–84PubMedCrossRef

Title: Breast carcinomas of low malignant potential
Authors: Stuart J. Schnitt
Falko Fend
Thomas Decker
Publication date: 01-01-2022
Publisher: Springer Berlin Heidelberg
Keyword: Fibromatosis
Published in: Virchows Archiv / Issue 1/2022
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-021-03163-w

At a glance: The STEP trials

Springer Medicine

Breast carcinomas of low malignant potential

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2022

Triple-negative breast carcinomas of low malignant potential: review on diagnostic criteria and differential diagnoses

Contemporary issues in breast pathology

Male breast cancer: an update

Papillary lesions of the breast

Sentinel lymph node assessment in breast cancer—an update on current recommendations

Incorporation of TILs in daily breast cancer care: how much evidence can we bear?