A CASE OF DIFFUSELY SPREADING NONINVASIVE DUCTAL CARCINOMA WITH LOW PAPILLARY CARCINOMA IN THE LEFT BREAST

Low papillary carcinoma of the breast is a relatively rare form of noninvasive ductal cancer that has peculiar histologic features. We experienced a nonpalpable breast cancer in which noninvasive ductal cancer including low papillary carcinoma diffusely spreaded in an expensive area (13×9cm). A 42-year-old female complaining of left nipple bloody discharge since 8 years was seen at the hospital.There was no palpable lesion in the breast, however, the CEA concentration in the nipple discharge was higher than 1000ng/ml, and a carcinoma was suspected by cytological examination of the nipple discharge. No sign of abnomality was revealed on echography, and no microcalcifications on mammography in the breast. However, ductgraphy from the left nipple showed irregularity and stenotic changes of the ducts. Left duct lobular segmentectomy was performed and histological examination revealed noninvasive ductal carcinoma including low papillary carcinoma in an extensive area of the removed specimen. Left modified mastectomy (Brt + Ax) was performed and histological findings revealed a noninvasive ductal carcinoma without lymph node metastasis, in spite of the fact that the tumor spreaded in a size of 13.0×9.0cm histologically. Careful examinations and treatment must be taken not to mistake the diffusely spreading breast cancer like this case.