A case of intracystic carcinoma of the breast is reported with a review of the Japanese literature. An 87-year-old woman was admitted to our department complaining of a lump in the left breast. Physical examination revealed an elastic firm, well-defined lump measuring 6.4 × 5.7 cm, in the outer quadrant near the nipple. Following a tentative diagnosis of intracystic carcinoma, partial resection of the mammary gland containing the tumor was done. Histological examination confirmed the diagnosis ofnoninvasive papillary carcinoma without intramural invasion.
Ultrasonographic examination has been considered to be useful for detection of intracystic papillary tumor, and the best diagnostic procedure for intracystic tumor of the breast is thought to be aspiration cytology of the intracystic tumor under ultrasonographically guided needle aspiration.
A total-of 80 cases of intracystic carcinoma of the breast including our case were reviewed and discussed. The frequency of lymph node metastasis was 17.6% of total cases, less than that of usual carcinoma of the breast. Histologically, papillotubular carcinoma and papillary carcinoma accounted for 67.1% of the cases. Frequency of invasion to the cyst wall was high, with32.1% of cases showing stromal invasion beyond the cyst wall.
Surgical operation is the first choice of treatment for intracystic carcinoma of the breast, and we consider modified or standard radical mastectomy most suitable for intracystic carcinoma.
In this case, tumor cells showed slight cellular atypism, but nuclear DNA analysis revealed an aneuploidy pattern and low values for the S-phase fraction and proliferative index. Nuclear DNA analysis is useful for the diagnosis of malignancy as well as histological examination.