A case of invasive papillary breast carcinoma: Fierce façade with favorable prognosis

Invasive papillary carcinoma of the breast: A case report

Invasive papillary carcinoma (IPC) of the breast is a rare form of cancer. The current report documents a case of IPC characterized by a large tumor size and skin involvement. Surgical exploration revealed no evidence of axillary lymph node metastasis in breast cancer. Due to financial constraints, the patient opted solely for anastrozole endocrine therapy at a dosage of 1 mg/day for a period of 5 years post-surgery, foregoing other treatments such as radiotherapy and chemotherapy. Since discharge, 2.5 years have passed, during which the patient has been followed up via phone every 3 months, showing a good prognosis. A literature review indicated that IPC is prevalent amongst the elderly population and can be misdiagnosed due to its morphological, cytomorphological and immunophenotypic overlap with other types of papillary neoplasms. This tumor exhibits a more favorable prognosis compared with IDC, primarily attributed to its advantageous gene and molecular expression patterns, coupled with its decreased invasiveness. Despite limited evidence-based research on the treatment of IPC, the present case report, albeit with limitations, underscores the importance of avoiding over-treatment and suggests the feasibility of combining surgery with endocrine therapy for IPC.

Invasive papillary carcinoma of the breast: a rare case report

Background

Invasive Papillary Carcinomas (IPC) are rare and account for approximately 0.5% of all invasive breast carcinomas. Most of them are seen in post-menopausal women and have a good prognosis. These tumors lack the myoepithelial cell layer (MCL) within the papillae or at the periphery of the tumor with areas showing stromal invasion or invasion into lymphovascular spaces. Immunohistochemistry (IHC) for myoepithelial cells and basement membrane is essential for the diagnosis of invasive cancer.

Case presentation

We present a rare case of IPC in a 74-year-old woman who presented with complaints of gradually increasing painless retroaerolar mass in the left breast of two months duration. The mass was irregular, having an oblong as well an adjacent high density mass lesion on mammography. Ultrasound (US), and Magnetic Resonance Imaging (MRI) helped in the diagnosis of the possibility of a malignant breast lesion. Left-sided modified radical mastectomy was performed and the specimen was histopathologically diagnosed as Invasive Papillary carcinoma. Immunohistochemistry confirmed the diagnosis.

Conclusions

Invasive Papillary Carcinomas of the breast are rare cancers in post-menopausal women. We have highlighted the role of Mammography, US, and MRI in early diagnosis so that timely management is possible.

Recombinant Expression and Purification of Cannabinoid Receptor CB2, a G Protein-Coupled Receptor

G protein-coupled receptors (GPCR) are integral membrane proteins that regulate multiple cellular processes. To obtain insights into structural properties of GPCR and mechanism of activity, these proteins should be isolated in significant (milligram) quantities, in a pure, homogenous, and stable form. Here we describe the expression and purification of type II human cannabinoid receptor CB₂, a class A GPCR, in two different types of expression hosts: in Escherichia coli and in mammalian suspension cell culture Expi293. Our method allows preparation of milligram quantities of the purified receptors suitable for a wide array of downstream applications including high-resolution structural studies and functional assays.