Abstract
We encountered a patient with non-invasive ductal carcinoma (DCIS) of the breast. The DCIS occurred 19 years after resection of the isolated central papilloma. A 68-year-old woman was detected at screening mammography to have segmental and pleomorphic calcifications in the right breast. The patient had a history of undergoing surgical resection of a tumor in her right breast 19 years ago. Histopathological examination of the resected sepecimen had revealed an isolated central papilloma. The surgical margin was positive. Ultrasonography revealed a hypoechoic area near the previous surgical wound. A core needle biopsy revealed the diagnosis of non-invasive ductal carcinoma. CT examination and bone scintigraphy revealed no evidence of distant metastasis. Muscle-preserving mastectomy plus sentinel lymph node biopsy was performed. The histopathological diagnosis was DCIS. Immunohistochemistry revealed positive test results for estrogen receptor and progesterone receptor expression and a negative test result for HER-2 expression. Administration of tamoxifen for 5 years was planned. At present, 4 years from the second surgery, the patient remains well without metastasis or local reccurence. Commonly, an isolated central papilloma is thought of as a benign tumor, and is believed to have low malignant potential. However, long-term monitoring appears to be necessary after resection of an isolated central papilloma.
