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Papillary and neuroendocrine breast lesions: the WHO stance

Tan, Puay Hoon; Schnitt, Stuart J.; van de Vijver, Marc J.; Ellis, Ian O.; Lakhani, Sunil R.


Puay Hoon Tan

Stuart J. Schnitt

Marc J. van de Vijver

Sunil R. Lakhani


In this review, we highlight adaptations in the WHO 2012 classification of papillary and neuroendocrine breast lesions as compared with the previous 2003 version. Consensus criteria for distinguishing atypical ductal hyperplasia from ductal carcinoma in situ within an intraductal papilloma are proposed. The absence of myoepithelial cells around the wall of an encapsulated papillary carcinoma, although raising consideration of an indolent tumour with minimal invasion, is currently regarded as in‐situ disease for staging purposes. The majority of solid papillary carcinomas are classified as in‐situ tumours, but lesions with irregular tumour islands within desmoplastic stroma may be considered to be invasive. The diagnosis of solid papillary carcinoma without further qualification as either in‐situ or invasive disease is discouraged. When invasive papillary carcinoma is seen in the breast, metastatic papillary carcinoma from other organ sites needs to be excluded. WHO 2012 classifies neuroendocrine breast tumours as well‐differentiated neuroendocrine tumour, small‐cell carcinoma, and invasive breast carcinoma with neuroendocrine differentiation. There is currently no clinical impact of identifying neuroendocrine differentiation in conventional invasive breast carcinomas, apart from acknowledging its frequent occurrence in subtypes such as the hypercellular variant of mucinous carcinoma and solid papillary carcinoma.


Tan, P. H., Schnitt, S. J., van de Vijver, M. J., Ellis, I. O., & Lakhani, S. R. (2015). Papillary and neuroendocrine breast lesions: the WHO stance. Histopathology, 66(6), 761-770.

Journal Article Type Article
Acceptance Date May 21, 2014
Online Publication Date Jan 23, 2015
Publication Date May 30, 2015
Deposit Date Dec 6, 2018
Journal Histopathology
Print ISSN 0309-0167
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 66
Issue 6
Pages 761-770
Public URL
Publisher URL