Management of Papillary Breast Lesions Diagnosed on Core-Needle Biopsy: Clinical Pathologic and Radiologic Analysis of 276 Cases with Surgical Follow-Up

Rizzo, M.; Linebarger, Jared H.; Lowe, Michael C.; Lin, Peng; Gabram, Sheryl G. A.; Vasquez, Leonel; Cohen, Michael A.; Mošunjac, Marina

doi:10.1016/j.jamcollsurg.2011.12.005

Cited by 87 publications

(84 citation statements)

References 22 publications

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“…These studies reported their rates of upgrade from benignity on core needle biopsy to malignancy and papilloma with atypia after surgical excision. 1,5,[7][8][9]11,15,16,25,28,29,[31][32][33][34][35][36] Our finding was within the range of the reported upgrade rate to papilloma with atypia. Age data are reported as mean ± SD (median, range).…”

Section: Discussionsupporting

confidence: 84%

“…Moreover, prior studies have shown that papillomas with atypia diagnosed at core needle biopsy were more often upgraded histologically to malignancy than benign papillomas after surgical excision. [2][3][4][5][6][10][11][12][13]25,33,34,38 Some studies reported atypical papilloma as a generalized risk factor for the development of breast cancer. [39][40][41] Therefore, surgical excision has been recommended as a management strategy for atypical papillomas at core needle biopsy.…”

Section: Sohn and Park-sonographically Guided Core Needle Biopsy And mentioning

confidence: 99%

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Comparison of Sonographically Guided Core Needle Biopsy and Excision in Breast Papillomas

Sohn

2013

Journal of Ultrasound in Medicine

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Objectives The aim of this study was to evaluate the clinical factors and sonographic features of benign papillomas of the breast proven by sonographically guided 14‐gauge core needle biopsy and their upgrade or malignancy rate after sonographically guided vacuum‐assisted excision or surgical excision. Methods We reviewed the medical records of patients who underwent core needle biopsy from July 2005 to December 2011. We evaluated 39 benign papillomas without atypia in 34 patients. The papillomas were diagnosed by core needle biopsy and underwent surgical or vacuum‐assisted excision. After core needle biopsy, imaging‐histologic correlation was performed to determine concordance. The upgrade and malignancy rates were assessed after surgical or vacuum‐assisted excision, and associated clinical and radiologic factors, including patient age, lesion size, distance from the nipple, sonographic features, and American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) category were evaluated. Results Three lesions (7.7 %) among 39 papillomas were upgraded to papilloma with atypia after surgical excision. There was no malignancy after excision. The upgrade rates for BI‐RADS categories 3, 4a, 4b, and 4c were 0%, 6.9%, 0%, and 20%, respectively. There were no significant differences in the upgrade to papilloma with atypia in terms of the presence of symptoms, lesion size, distance from the nipple, BI‐RADS category, or imaging‐histologic correlation. Conclusions Prediction of papilloma with atypia, not malignancy, was challenging because there were no associated clinical or radiologic factors to predict papilloma with atypia before excision. However, there was no malignancy after excision. Therefore, intensive surveillance is preferable to immediate surgical excision for benign papillomas diagnosed on core needle biopsy.

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Section: Discussionsupporting

confidence: 84%

Section: Sohn and Park-sonographically Guided Core Needle Biopsy And mentioning

confidence: 99%

Comparison of Sonographically Guided Core Needle Biopsy and Excision in Breast Papillomas

Sohn

2013

Journal of Ultrasound in Medicine

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“…However, due to the risk of associated atypia or ductal carcinoma in situ of these lesions and to frequent upgrade to high-risk lesions or cancer of papillomas diagnosed on core needle biopsy, excision should be reccomended for all papillary lesions [2,3,13] Multiple or peripheral intraductal papillomas, also known as papillomatosis, is characterized by papillary proliferations within multiple terminal ductal lobular units or in the distal branches of the ductal system. Papillomatosis is more likely to occur bilaterally, in the 4 th -5 th decade of life and is more frequently associated with hyperplasia, atypia, DCIS, or invasive carcinoma [1,3].…”

Section: Benign Papillary Lesionsmentioning

confidence: 99%

Ultrasound in the diagnosis of papillary breast lesions

Ciurea

Calin²,

Ciortea³

et al. 2015

Med Ultrason

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Papillary lesions are defined as an amalgam of various lesions which represent a diagnostic challenge, for both the radiologist and pathologist. They are diagnosed on the basis of a combination of clinical, imaging, and pathological findings and their features carry differing prognostic implications for the affected patients. The aim of this pictorial essay is to review the clinical and pathological findings in papillary breast lesions, to show the advantages and limits of each imaging method in their diagnosis with emphasis on the importance of ultrasound in the differential diagnosis. Also, the spectrum of ultrasound features (conventional, Doppler ultrasound and elastography) of papillary lesions of the breast will be illustrated.

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“…Santral lezyonlarda akıntı yakınması olabilir, periferik multipl papillomlar genellikle asemptomatiktir. Kalın iğne biyopsilerinin artması ile birlikte papiller meme lezyonlarının görülme sıklığı son 10 yıl-da artmıştır [46].…”

Section: Papillomunclassified

“…Rizzo ve ark. [46] 234 olguluk serilerinde, eksizyon sonrası %17,9 ADH, %8,1 DKİS ve %0,9 invaziv duktal karsinom saptamışlardır. Bu nedenle bazı araştırıcılar tüm papiller lezyonlarda eksizyon önermektedir [49].…”

Section: Papillomunclassified

Radyolojik-Patolojik Korelasyon: Yüksek Risk Lezyonlarda Ne Yapmalıyız?

Oktay¹

2014

Trd Sem

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Management of Papillary Breast Lesions Diagnosed on Core-Needle Biopsy: Clinical Pathologic and Radiologic Analysis of 276 Cases with Surgical Follow-Up

Cited by 87 publications

References 22 publications

Comparison of Sonographically Guided Core Needle Biopsy and Excision in Breast Papillomas

Comparison of Sonographically Guided Core Needle Biopsy and Excision in Breast Papillomas

Ultrasound in the diagnosis of papillary breast lesions

Radyolojik-Patolojik Korelasyon: Yüksek Risk Lezyonlarda Ne Yapmalıyız?

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