Mammotome biopsy in diagnosing and treatment of intraductal papilloma of the breast

Abstract

Vacuum-assisted core biopsy is a minimally invasive and efficient method used for diagnosing intraductal papilloma of the breast. If histopathological examination confirms a benign character of the lesion, surgery may be avoided but regular follow-up is recommended. However, in all cases histopathological diagnosis of papilloma with atypical hyperplasia, should always be indication for surgical excision.

Ultrasound‐guided 7‐gauge vacuum‐assisted core biopsy: Could it be sufficient for the diagnosis and treatment of intraductal papilloma?

“…In this study, intraductal papillomas without atypical hyperplasia had a significantly higher excision rate than that of papillomas with atypical hyperplasia. The study of Kibil et al reported that three intraductal papillomas with atypical hyperplasia revealed to be invasive cancers by surgery. Hence, they concluded that all cases histopathological diagnosis of papilloma with atypical hyperplasia should always be indication for surgical excision.…”

“…In this study, hematoma was seen in 12 lesions (11.9%) after the procedure. Kibli et al reported that after the vacuum‐assisted core biopsy with 10‐gauge or 11‐gauge core needles, the chance of hematoma was 4.8%. Hematoma was rarely seen after 14‐gauge core needle biopsy .…”

“…The management of intraductal papillomas without atypia of the breast remains controversial . There have been some reports on the effectiveness of vacuum‐assisted core biopsy (VACB) in the diagnosis and treatment of intraductal papilloma of the breast . But until now, there have been no systematic studies on the lesion characteristics and histologic features that might affect the exicision rate of VACB.…”

Management of papillary lesions of the breast diagnosed by core biopsy: Need for an evidence‐based standard of care

“…These latter two studies support the conclusion by Wang et al in this issue of The Breast Journal that use of a 7 gauge breast needle and a greater number of samples might eliminate the need for a subsequent excisional biopsy for a benign papilloma found at core biopsy . Nevertheless, the study by Wang et al reported a 10% rate of hematoma, which may be compared to a 4.8% rate of hematoma reported by Kibil following biopsy with a 10 or 11 gauge needle …”

“…Some studies such as Carder et al, Kibil, et al, Wang, et al in this issue of the Breast Journal, Yamaguchi, et al, Mosier, et al, and Youk, et al suggest that the entire papilloma be completely removed and managed by core biopsy if the lesion is very small or if a relatively large amount of tissue is removed.…”