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Welcome, Fitness, to the club with very few wanna-be members. I'm sorry you find yourself here with us. Given that papillary carcinoma is more rare than conventional types of breast cancer, there aren't that many of us here. But here's a papillary thread for more info: https://community.breastcancer.org/forum/137/topic...

Regardless of whether your core biopsy pathology showed an in situ (papillary tumor contained within the duct) presentation or one associated with invasive cells (IDC-NST for example), until the papillary mass is surgically removed they really won't know if and what type(s) of invasive components are present. It's common for DCIS (non-invasive pre-cancer) to be found adjacent to papillary tumors, which is not always evident from a core biopsy.

Papillary tumors can sometimes, although not often, present in multiples, so it might be advisable for you to ask for a pre-surgical bilateral breast MRI scan, if you haven't already had an MRI. Papillary masses are not always seen on ultra-sound. And a MRI might help to assess how much DCIS, if any, is present.

It never hurts to get a 2nd opinion on the pathology, as it's possible there might be some associated invasion that's being missed in your 1st pathology. This might help you reach a decision you're more comfortable with.

A couple years ago I had an excisional biopsy with clear margins which removed a papillary tumor with an unpleasant surprise of multi-focal invasions of mixed carcinomas. The papillary tumor was very fast-growing and 2nd opinion pathologies all differed. If I knew then, what I know now, I would not have let them talk me into conservative treatment. But this is just my opinion.

There are medical studies that indicated that radiation after conservative surgery (lumpectomy) did not influence the outcome in papillary carcinoma cases, with or without invasion. I've noticed the majority of of the papillary ladies on this board have had mastectomies, although a couple had also recurred in cases where they had associated invasion where the tumors were close to their chest wall, if I remember correctly. Please let us know how we can be of further support. Please visit the papillary threads.

Hugs to you!