Introduction: Papillary lesions are a group of lesions characterized by presence of papillae supported by fibrovascular cores lined by epithelial cells with or without myoepithelial cells. This group of lesions span spectrum of hyperplastic to neoplastic processes. Diagnosis of papillary lesions is challenging for pathologists. Distinction between various lesions as benign, atypical and malignant papillary lesions aid in patient management. Materials and methods: This is a five years study from January 2013 - December 2017. All the cases diagnosed as papillary lesions were considered for the study. Total of 21 cases were reviewed. All the patient details were archived from patient’s records. Paraffin blocks were also archived and IHC for p63, CK5/6, ER, PR and Her2/Neu were performed. Histopathology slides were reviewed by pathologists who were blinded about the original diagnosis. Aims: This study was conducted to analyse the clinico-pathological and immunohistochemical characteristics of papillary lesions of the breast. Results: Age ranged from 29-61 years. Only 2 cases presented with bloody nipple discharge. Male – female ratio was 1:8.5. Majority of the specimen were lumpectomy, followed by modified radical mastectomy and biopsies. Diagnosis of papilloma was made in 6 cases, while remaining 13 cases were diagnosed as papillary carcinoma. Adjacent breast showed changes like inflammation, fibrocystic change, atypical ductal hyperplasia, carcinoma in situ and invasive carcinoma. IHC showed positivity for ER in 10 cases, PR in 9 cases and Her2/neu in 1 case. P63 showed continuous positivity in papillomas but negative in carcinomas. Conclusion: Papillary lesions of breast can range from hyperplastic to neoplastic lesions. Accurate diagnosis will aid in patient management. Immunohistochemistry will help in delineating the lesions.

Keywords: Papillary lesions; Papilloma; Papillary carcinoma; IHC.