Papillary Breast Carcinomas are rare, seen predominantly in postmenopausal women between the sixth and eighth decade, and have a good prognosis. Clinically they can be asymptomatic or present with bloody nipple discharge,or an abnormal palpable mass. Mammography can show a round, oval or irregular high-density mass, sometimes associated with satellite nodules, and margins are circumscribed but may be obscured or indistinct. Accompanying microcalcification or a dilated ductal pattern may be present .
Ultrasonic evaluation of Invasive Papillary Carcinoma reveals a hypoechoic solid mass commonly accompanied with posterior acoustic enhancement. Complex cystic and solid masses with increased vascularity in the solid area can be seen. There can be associated ductal dilation with intra ductal solid mass .
Limited experience is available for Magnetic Resonance Imaging of IPC. On MRI, papillary carcinomas may appear as irregular enhancing nodules or enhancing complex cysts. Morphological features, as well as kinetic curves of IPC, are variable on MRI. MRI helps in the pre-operative mapping of multiple papillary lesions, thereby facilitating optimal surgical planning .
Fine needle aspiration cytology [FNAC] reveals atypical cells in the smear. Sonography-guided vacuum-assisted core biopsy is a much better option than aspiration cytology. The gun biopsy mainly hits the solid center of the tumor and the invasive component can only be recognized at the periphery of the tumor, so excisional biopsy of papillary lesions is an effective approach to demonstrate invasion . Malignant papillary neoplasm of the breast includes several microscopically distinct lesions such as DCIS (Ductal Carcinoma in Situ) arising in intra ductal papilloma, papillary DCIS, encapsulated papillary carcinoma, solid papillary carcinoma, and invasive papillary carcinoma. All malignant papillary lesions of the breast lack an intact myoepithelial cell layer (MCL) within the papillae or at the periphery of the tumor .
IHC is very useful in the assessment of myoepithelial cells and basement membrane for the diagnosis of invasive cancers. The Myoepithelial cells are absent in invasive cancers. There are many known myoepithelial markers such as S-100, Calponin, CD 1O, smooth muscle myosin heavy chain, alpha-smooth muscle actin, P63, and high molecular weight Cytokeratin with different sensitivities and specificities. Of these P63 and smooth muscle, myosin is more specific. A special myoepithelial marker P63 stains the cell muscles only . Genetic Features may help in distinguishing papillary carcinoma from benign lesions. Loss of heterozygosity (LOH) of 16q23 is specific to the malignant lesion. Alternation in chromosomes 3,7,17 and X using multicolor fluorescence in situ hybrididization was noticed in DNA—aneuploid carcinoma. So DNA –ploidy in association with changes in specific loci helps in the diagnosis of papillary carcinoma 
The overall prognosis of Invasive Papillary Carcinoma is better than other breast malignancies such as infiltrating duct carcinoma. Treatment options are wide local excision, with or without adjuvant radiotherapy or chemotherapy. Tamoxifen is an important drug as this cancer seems to be almost certainly hormonal positive and HER -2 negative [7, 8].
According to Hesham and Almohamady, malignancy is more common if an Intraductal mass fills the duct and extends outside the duct with a distance from the nipple more than 1.5 cm. In our case also the mass was filling the duct as well as extending outside the duct and was 1.8 cm away from the nipple thus favoring the malignant nature of the mass . Ultrasound and MRI can help in making a diagnosis of Invasive Papillary Carcinoma of the breast.