Outcome of Non-Malignant Papillary Lesions of the Breast on Core Biopsy: An Experience from a Tertiary Care Center in Pakistan

Abstract

Background Papillary lesions of the breast constitute a heterogeneous group ranging from non-malignant papillomas to papillary carcinoma. While surgical excision is recommended for atypical papilloma or papillary DCIS/ carcinoma on core biopsy, controversy persists in the management of benign papillomas which are diagnosed with core needle biopsy (CNB) since there are variable reported rates for tumor upgrade. The purpose of this study was to determine the outcome of papillary lesions of the breast diagnosed at image-guided CNB, after surgical excision or follow-up, and to identify potential predictors of high-risk lesions/malignancy on imaging.

Papillary Neoplasm of Breast-Changing Trends in Diagnosis and Management

“…The treatment of benign and atypical papilloma is being evolved. The surgical excision of all papillary lesions is recommended for definitive diagnosis and standard management for malignant papillary lesions [24,30]. Li X et al suggested the vacuum assisted excision is applicable for complete excision of small papillomas, even papillomas with atypical hyperplasia [31].…”

“…Accurate results and coordination between a trained radiologist and pathology are of utmost importance in the decision making between follow-up or surgery [35]. However, Fatima K et al have observed no reliable clinical or imaging features that can pre-surgically predict atypical upgradation or malignant potential [30]. Tokiniwa H and fellows detected surgical excision advantageous for papillary lesions especially for the lesions located far from the nipple [36].…”