{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:47:27Z","timestamp":1785757647210,"version":"3.56.0"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Encapsulated papillary carcinoma (EPC) of the breast is an uncommon tumour with controversial biological behaviour and staging. Emerging evidence suggests that EPC with adverse pathological features (EPC\u2010A) may exhibit invasive potential. The absence of uniform staging criteria contributes to management variability. This study evaluates the clinicopathological characteristics and clinical course of high\u2010grade EPC (HG\u2010EPC), including EPC\u2010A.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective multicentre study (2000\u20132025) included 25 HG\u2010EPC cases, irrespectively of ER\/PR and HER2 status. Tumours with frank stromal invasion beyond microinvasive foci were excluded. Histopathological re\u2010evaluation was performed in accordance with 2019 WHO classification criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 38 cases reviewed, 25 fulfilled the inclusion criteria as EPC (mean age 57.2\u2009years, mean tumour size 2.9\u2009cm). Six cases (24%) demonstrated conventional\u2010type microinvasive components. A subset of 16 cases fulfilled criteria for EPC\u2010A, defined by high\u2010grade morphology in combination with ER\/PR\u2010negative (or ER &lt;30% positive) and\/or HER2\u2010positive status. Staging and management were variable. Initial pathological stage varied: pTis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) to pT1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) or pT2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), and pT3 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Adjuvant chemotherapy and radiotherapy were administered in 7 and 12 patients respectively. During follow\u2010up, four local recurrences (three invasive and one\n                      <jats:italic>in situ<\/jats:italic>\n                      ) were observed. One of the locally recurrent patients subsequently developed distant metastasis, and one breast cancer\u2010related death occurred 200\u2009months after diagnosis. Recurrence or death occurred in 20% (5\/25) of patients despite therapy. Microinvasion was seen only in the EPC\u2010A tumours.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      HG\u2010EPC and EPC\u2010A overlap morphologically and diagnostically with frankly invasive carcinomas and demonstrate a non\u2010negligible risk of recurrence. Clinical outcomes and more frequent microinvasion in EPC\u2010A support the view that EPC\u2010A is more appropriately regarded as an indolent form of invasive carcinoma rather than a purely\n                      <jats:italic>in situ<\/jats:italic>\n                      lesion and demonstrate a non\u2010negligible risk of recurrence and highlight the need for standardized staging criteria.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/his.70240","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:14:33Z","timestamp":1785755673000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term outcome of high\u2010grade encapsulated papillary carcinoma of the breast: implications for staging and management"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7463-7789","authenticated-orcid":false,"given":"Milena","family":"Stevanovic","sequence":"first","affiliation":[{"name":"Department of Pathology and Molecular Pathology University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5009-5525","authenticated-orcid":false,"given":"Emad","family":"Rakha","sequence":"additional","affiliation":[{"name":"School of Medicine University Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian O.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Histopathology Nottingham University Hospitals NHS Trust  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Maccio","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Pathology University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e4rbel","family":"Papassotiropoulos","sequence":"additional","affiliation":[{"name":"Breast Center Seefeld  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-8408","authenticated-orcid":false,"given":"Hisham","family":"Fansa","sequence":"additional","affiliation":[{"name":"Breast Center, Hospital Zollikerberg  Zollikerberg Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidija","family":"Stevanovic","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Gynecology University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Frauchiger\u2010Heuer","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Gynecology University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8734-4521","authenticated-orcid":false,"given":"Isabell","family":"Witzel","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Gynecology University Hospital Zurich  Zurich Switzerland"},{"name":"Comprehensive Cancer Center University Hospital Zurich  Zurich Switzerland"},{"name":"University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2855-983X","authenticated-orcid":false,"given":"Zsuzsanna","family":"Varga","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Pathology University Hospital Zurich  Zurich Switzerland"},{"name":"Comprehensive Cancer Center University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"WHO classification of tumours of the breast","author":"WHO Classification of Tumours EB","year":"2012"},{"key":"e_1_2_12_3_1","volume-title":"WHO classification of tumours of the breast","author":"WHO Classification of Tumours 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Histopathol."},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2018.03.005"},{"key":"e_1_2_12_24_1","first-page":"66","article-title":"Diagnosis, treatment, and outcomes of encapsulated papillary carcinoma: A single institution experience","volume":"25","author":"Steponaviciene L","year":"2018","journal-title":"Acta Med Litu."},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5855"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2023.14046"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200608000-00011"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14786"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2025.105902"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.14153"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.20344\/amp.11737"},{"key":"e_1_2_12_32_1","volume-title":"WHO classification of tumours of the breast","author":"WHO classification of Tumours EB","year":"2026"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00425-2"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70135-9"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra031301"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-020-05680-9"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.70240","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/his.70240","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.70240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:14:35Z","timestamp":1785755675000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.70240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":35,"alternative-id":["10.1111\/his.70240"],"URL":"https:\/\/doi.org\/10.1111\/his.70240","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"assertion":[{"value":"2026-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"his.70240"}}