title: Diagnostic Pitfalls in Papillary Lesions of the Breast: Experience from a Single Tertiary Care Center.
abstract: BACKGROUND
  Papillary neoplasms are a group of lesions that are characterized by presence of papillae supported by fibrovascular cores lined by epithelial cells with or without myoepithelial cell layer. These neoplasms may be benign, atypical or malignant.
  
  
  OBJECTIVE
  This study was conducted to analyse the clinicopathological characteristics of papillary lesions of the breast.
  
  
  METHODS
  A retrospective and prospective analysis of 34 cases of papillary lesions received over a period of 7 years from 2009 to 2015 was done. The patient's clinical details were collected from medical archives and the histopathological findings were reviewed. The lesions were classified into benign, atypical and malignant categories.
  
  
  RESULTS
  During the study period, there were 34 cases of papillary lesions of breast. The mean age was 58 years. The central quadrant was the most common location (66.6%). The most common presenting complaint was lump (76.5% cases). Papillary lesions presented more commonly as solitary lump (82.4%) rather than multifocal disease. Benign papillary lesions were more common than the atypical and malignant lesions. The most common papillary lesion accounting for 43% of the cases was intraductal papilloma. Malignant lesions accounted for 41.2% cases with intraductal papillary carcinoma and invasive papillary carcinoma constituting 14.7% cases each.
  
  
  CONCLUSIONS
  Diagnosis of papillary carcinoma is challenging and its classification includes different entities that have specific diagnostic criteria. Due to their heterozygosity in morphology with benign, atypical and malignant subtypes, morphological features such as type of fibrovascular core and continuity of myoepithelial layer along with immunohistochemical stains for myoepithelial cells should be considered for proper and accurate diagnosis.
authors.affiliation: Associate Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Sridevi Hanaganahalli
authors.initials: SH
authors.lastname: Basavaiah
authors.affiliation: Assistant Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Jessica
authors.initials: J
authors.lastname: Minal
authors.affiliation: Postgraduate Student, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Saraswathy
authors.initials: S
authors.lastname: Sreeram
authors.affiliation: Assistant Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Pooja Kundapur
authors.initials: PK
authors.lastname: Suresh
authors.affiliation: Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Hema
authors.initials: H
authors.lastname: Kini
authors.affiliation: Associate Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Deepa
authors.initials: D
authors.lastname: Adiga
authors.affiliation: Additional Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Kausalya Kumari
authors.initials: KK
authors.lastname: Sahu
authors.affiliation: Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
authors.forename: Radha R
authors.initials: RR
authors.lastname: Pai
keywords: Fibrovascular core; Myoepithelial; Papilloma