The lesion is pos for ER/PR. So metastatic tumor can be excluded basically.

It is a papillary breast lesion.  If p63 and actin stains in floor 11 can represent the entire lesion. You need to review the glass slides carefully to make sure if the focal atypica is present.  If yes you may consider the dx of atypical papilloma. Mostly it is just introducatal papilloma with UDH and sclerosing based on the photos above.

Wish more people share your oppinion.

 谢谢姜老师指点，刚才查资料，见到一个综述，挺好的，看完基本明白了。连接如下：

http://arpa.allenpress.com/arpaonline/?request=get-document&doi=10.1043%2F1543-2165-133.6.893

 Interesting case.

There are different classification of papillary lesions.

generally papillary lesions include intraductal papilloma (bengin), atypical papilloma, DCIS arising from papilloma, papillary carcinoma (papillary DCIS). The key is myoepithelial. If you are not sure it is benign or atypical or malignant, do myoepithelial stains. If myoepithelial cells are totally lost within the papillary lesion, it is  papillary carcinoma.

For above case, I feel the myoepithelial layer are present. Any way I will do myoepithelial stains if I am not sure.

此次免疫组化，示ki-67和34be12。因p63一个阳性细胞也没有，未上传（切片暂借出）。