Encapsulated Papillary Carcinoma of the Breast Clinicopathological Features and Management: Could Sentinel Lymph Node Biopsy Be Exempted?

Abstract

Abstract Background Any papillary lesion in the breast presents a diagnostic and therapeutic challenge. Encapsulated papillary carcinoma (ECP) is one of the rare types of breast cancer. Evidence-based guidelines are sparse. For this reason, there is no complete clarity in the diagnosis and treatment management, and there are not enough studies in the literature. This study aims to examine the necessity of sentinel lymph node sampling in the management of ECP in line with the patients' clinicopathological data. Methods We retrospectively screened with EPC in our clinic between January 2012 and March 2022. We recorded and statistically evaluated the patients' demographic, clinical, radiological, pathological, and treatment management. Results Sixty four EPC patients were identified. The final pathologic evaluation revealed that 19 patients (18.7%) had pure EPC, 27 patients (43.7%) had EPC with associated DCIS, and 18 patients (37.5%) had EPC associated with invasion. The mean age was 61, and 2 patients were male. Breast-conserving surgery was performed in 62 patients, and simple mastectomy was performed in 2. SLNB was found to be positive in only 1 of the patients. Sixty-three patients with EPC were hormone receptor-positive, one patient was triple negative, and they were associated with invasion. No death was in any patient; one had local recurrence, and a mastectomy was performed. Conclusions The overall prognosis and long-term survival of EPC is excellent. Our study and current literature indicate routine SLNB is overtreatment since surgical excision with negative margins is sufficient in EPC cases, and lymph node metastasis is rare, even with an invasive component.