Papillary breast cancer

The term papillary breast cancer can refer to a number of different types of breast cancer. These include:

• Invasive papillary breast cancer
• Invasive micropapillary breast cancer
• Intracystic/encapsulated/encysted papillary cancer
• Papillary ductal carcinoma in situ

They’re often found alongside other types of breast cancer.

The treatment and outlook (prognosis) for papillary breast cancer will depend on the type of papillary breast cancer as well as its features.

Papillary breast cancer is not the same as the benign (not cancer) condition intraductal papilloma.

As with most types of breast cancer, the symptoms of papillary breast cancer can include:

• A lump or swelling in the breast
• Changes to the nipple
• A change in the size of the breast

Breast screening can pick up cancer before there are any symptoms. You may have been diagnosed with papillary breast cancer after attending breast screening without having any symptoms.

Papillary breast cancer is diagnosed using a range of tests. These may include:

• A mammogram
• An ultrasound scan
• A core biopsy of the breast and sometimes lymph nodes
• A fine needle aspiration (FNA) of the breast and sometimes lymph nodes

Treatment will depend on the type of papillary breast cancer you have and if another type of breast cancer is also found.

The treatments you’re offered will also depend on the features of the cancer such as the:

• Size
• Grade
• Hormone receptor status
• HER2 status

Surgery

If you have papillary breast cancer, surgery is likely to be the first treatment you’re offered.

There are 2 main types of surgery:

• Breast-conserving surgery, also known as wide local excision or lumpectomy – removal of the cancer with a margin (border) of normal breast tissue around it
• Mastectomy – removal of all the breast tissue usually including the nipple area

The type of surgery you’re recommended will depend on:

• Where the cancer is in the breast
• The size of the cancer relative to the size of your breast
• Whether more than 1 area in the breast is affected

If you have breast-conserving surgery, it’s important the cancer is removed with a border (margin) of healthy breast tissue around it. This is to reduce the risk of any cancer cells being left behind. If there are cancer cells at the margin, you may need further surgery to remove more tissue, which may be a mastectomy.

Most women who have a mastectomy will have the option to have breast reconstruction.

Surgery to the lymph nodes under the arm

If you have an invasive type of papillary breast cancer, your treatment team will want to check if any of the lymph nodes (glands) under the arm contain cancer cells.

This, along with other information about your breast cancer, helps them decide whether you’ll benefit from any additional treatment after surgery.

Find out more about surgery to the lymph nodes.

If you have intracystic/encapsulated/encysted papillary breast cancer or papillary carcinoma in situ, you’re less likely to have surgery to the lymph nodes. This is because these types rarely spread to the lymph nodes.

Other treatments

Depending on the type of papillary breast cancer you have, you may need other treatments after surgery. These can include:

• Radiotherapy
• Hormone therapy
• Chemotherapy
• Targeted therapy
• Bisphosphonates

These treatments aim to reduce the risk of breast cancer returning in the same breast or spreading somewhere else in the body. Which treatments you’re recommended will depend on your individual situation.  

Treatments given after surgery are called adjuvant treatments.

Some of these treatments may be given before surgery. This is known as neo-adjuvant or primary treatment. 

Radiotherapy

If you have breast-conserving surgery, you’ll usually be offered radiotherapy to the breast. This is to reduce the risk of cancer coming back in the same breast.

Radiotherapy is sometimes given to the chest wall after a mastectomy.

Hormone (endocrine) therapy

Some breast cancers use the hormone oestrogen in the body to help them grow. These are known as oestrogen receptor positive or ER-positive breast cancers.

Hormone therapies block or stop the effect of oestrogen on breast cancer cells. Different hormone therapy drugs do this in different ways.

Hormone therapy will only be prescribed if your breast cancer is ER-positive.

Chemotherapy

Chemotherapy destroys cancer cells by affecting their ability to divide and grow.

Chemotherapy may be recommended for some people who have an invasive type of papillary breast cancer.

Targeted therapies

This is a group of drugs that block the growth and spread of cancer. They target and interfere with processes in the cells that help cancer grow.

The type of targeted therapy you’re given will depend on the features of your breast cancer.

The most widely used targeted therapies are for HER2 positive breast cancer. HER2 is a protein that helps cancer cells grow.

Papillary cancers are much less likely to be HER2 positive than some other types of breast cancer.

Bisphosphonates

Bisphosphonates are a group of drugs that can reduce the risk of breast cancer spreading in women who have been through the menopause. They can be used if the menopause happened naturally or because of breast cancer treatment.

Your treatment team can tell you if bisphosphonates would be suitable for you.

You'll continue to be monitored after your hospital-based treatments (such as surgery, chemotherapy or radiotherapy) finish. This is known as follow-up.

Whether you had breast-conserving surgery or a mastectomy (with or without reconstruction), it's important to be aware of any changes to the breast, chest or surrounding area.

The area around your scar may feel lumpy, numb or sensitive. This means you'll need to get to know how it looks and feels so you know what’s normal for you. This will help you feel more confident about noticing changes and reporting them early to your breast care nurse, treatment team or GP.

Having breast cancer in one breast means the risk of developing cancer in the other breast (a new primary breast cancer) is slightly higher than in someone who's never had breast cancer. It’s important to be aware of any new changes in the other breast and to report these as soon as possible.

If you’ve been diagnosed with breast cancer, you might be feeling lonely or isolated. It’s completely natural to have these feelings.

You might find it helps to talk to someone who has been through a similar experience. Find out about our Someone Like Me service below.

You can also visit our confidential online forum and talk to other people affected by breast cancer.

You can also speak to our nurses on our free helpline, below.