Wei Shi
From the Department of Pathology, University of Alabama at Birmingham.
Arch Pathol Lab Med. 2016 Jul;140(7):628-43. doi: 10.5858/arpa.2015-0092-RA.
-Papillary lesions of the breast, characterized by the presence of arborescent fibrovascular cores that support epithelial proliferation, constitute a heterogeneous group of neoplasms with overlapping clinical manifestation and histomorphologic features, but may have divergent biological behavior. These lesions are exclusively intraductal neoplasms, although an invasive carcinoma may rarely have a predominantly papillary architecture. Although recognition of a papillary architecture is typically not challenging, the histologic distinction of these entities is not always straightforward. Historically, different terminologies and variable criteria have been proposed for a given entity by various authorities. The difficulty in classifying these lesions has been further confounded by the scarcity of data and the heterogeneity across different studies with regard to the molecular genetic characteristics of this group of lesions.
-To provide an overview focusing on the current concepts in the diagnosis and classification of papillary lesions of the breast incorporating recent molecular genetic advances.
-Data were obtained from pertinent peer-reviewed English-language literature.
-The recent evolution of molecular techniques has enhanced our knowledge of the pathogenesis of papillary carcinomas of the breast. This, along with emerging outcome studies, has led to prognosis-based reclassification of some of these entities. Additional studies focusing on the molecular signatures are needed to identify potential decision tools to further stratify these lesions with respect to prognostic significance.
乳腺乳头状病变以存在支持上皮增殖的树枝状纤维血管轴心为特征，构成了一组异质性肿瘤，其临床表现和组织形态学特征相互重叠，但生物学行为可能不同。这些病变均为导管内肿瘤，尽管浸润性癌很少主要呈乳头状结构。虽然识别乳头状结构通常并不困难，但区分这些实体的组织学特征并非总是一目了然。历史上，不同权威机构针对特定实体提出了不同的术语和可变的标准。由于数据稀缺以及不同研究在这组病变分子遗传特征方面的异质性，对这些病变进行分类的难度进一步加大。
提供一个综述，重点关注结合近期分子遗传学进展的乳腺乳头状病变诊断和分类的当前概念。
数据来自相关的同行评审英文文献。
分子技术的最新进展增进了我们对乳腺乳头状癌发病机制的了解。这与新出现的结局研究一起，导致对其中一些实体进行基于预后的重新分类。需要更多关注分子特征的研究，以确定潜在的决策工具，进一步根据预后意义对这些病变进行分层。
