Carcinoma Papillare Intracistico

Il carcinoma papillare intracistico (IPC) è un’entità rara di tumore della mammella (0,5-1% di tutti i carcinomi mammari), che viene diagnosticato di solito nelle donne in post-menopausa; può presentarsi come IPC puro, come IPC associato ad un DCIS o, meno frequentemente, come IPC associato ad un carcinoma invasivo a basso rischio di recidiva loco-regionale (55,56).

L’escissione chirurgica della lesione con margini negativi sufficientemente ampi (≥ 2 mm) rappresenta l’approccio terapeutico di scelta.

Il ruolo della terapia adiuvante è stato indagato soltanto in pochi studi, che comprendevano un numero limitato di pazienti (56). Viene consigliata la biopsia del linfonodo sentinella, per la possibilità di riscontro di un carcinoma invasivo nel referto istologico definitivo e la radioterapia

sull’intera mammella residua dopo chirurgia conservativa (56,57).

La mastectomia skin e/o nipple sparing, con la possibilità di una ricostruzione immediata, viene riservata alle lesioni di dimensioni più ampie o qualora la chirurgia conservativa non consenta un buon risultato cosmetico. Nei casi con recettori ormonali positivi, che sono molto frequenti, si può proporre la terapia ormonale (56).

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