Abstract:

Objective To investigate the ultrasonic imaging and pathological features of encapsulated papillary carcinoma and ductal carcinoma in situ of breast. Methods The clinical data of 7 cases of encapsulated papillary carcinoma and 12 cases of ductal carcinoma in situ were retrospectively analysed, and there were preoperative ultrasonic findings and images for all cases. The pathological features of tumor tissues were observed with HE staining, and the expression of estrogen receptor (ER), progesterone receptor (PR), p53, Ki67, p63 and CerbB-2 protein was detected by immunohistochemical method. Results The ultrasonic findings of encapsulated papillary carcinoma indicated that the masses were in irregular shape with unclear boundaries; internal echo was mixed echo; in case of no echo, high echo was found with papillae, and rear echo was enhanced; calcification was not found; and blood flow signals were visible around the tumor. The ultrasonic findings of ductal carcinoma in situ indicated that there was mammary duct ectasia; low echo was in the mammary duct ectasia, with irregular shape, unclear boundaries and no enhancement in the rear echo; calcification was found; and blood flow signals were visible around the tumor. Light microscopy with HE staining indicated that in encapsulated papillary carcinoma, fine fibrovascular cores were found, and neoplastic epithelial cells were of low or intermediate nuclear grades surrounded by a fibrous capsule. And in ductal carcinoma in situ, there was neoplastic proliferation cytological atypia of epithelial cells, and fibrovascular cores with no fibrous capsule were found in the nipple type ductal carcinoma in situ. Immunohistochemical detection revealed that in encapsulated papillary carcinoma, there was significantly positive expression of ER and PR and negative or weakly positive expression of p53, Ki67 and CerbB-2 in epithelial cells, and p63 was negative in myoepithelial cell layer within the papillae or at the periphery of the lesion. And in ductal carcinoma in situ, p63 was negative in myoepithelial cells within the papillae, but was positive in the cells at the periphery of the lesion. ConclusionThe unique ultrasonic imaging and pathological features are helpful in the diagnosis of encapsulated papillary carcinoma and ductal carcinoma in situ of breast.

Key words: tumor of breast, papillary carcinoma, ductal carcinoma in situ, ultrasonography, pathology