Papillary and sclerosing lesions of the breast detected and biopsied by MRI: Clinical management, upgrade rate, and association with apocrine metaplasia

Ring, N J; diFlorio-Alexander, Roberta; Bond, Jesse S; Rosenkranz, Kari M.; Cervantes, Eduardo; Sohn, Jae Ho; Marotti, Jonathan D.

doi:10.1111/tbj.13238

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…Heller et al documented an upgrade rate of 8% for papillary lesions. These results may suggest that recent guideline recommendations might also apply on high-risk patients with papillary and sclerosing lesions detected and biopsied by MRI-VAB [75,76]. Histologic diagnosis of papillary lesions is still challenging.…”

Section: Future Perspectivementioning

confidence: 96%

Papillary Lesions of the Breast: A Review

González

Ibargüengoitia

Corona

et al. 2020

Breast Cancer Manag.

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Papillary breast lesions are rare breast tumors that comprise a broad spectrum of diseases. Pathologically they present as mass-like projections attached to the wall of the ducts, supported by fibrovascular stalks lined by epithelial cells. On mammogram they appear as masses that can be associated with microcalcifications. Ultrasound is the most used imaging modality. On ultrasound papillary lesions appear as homogeneous solid lesions or complex intracystic lesions. A nonparallel orientation, an echogenic halo or posterior acoustic enhancement associated with microcalcifications are highly suggestive of malignancy. MRI has proven to be useful to establish the extent of the lesion. Core needle biopsy is the gold standard for diagnosis. Surgical excision is usually recommended, although treatment for papillomas without atypia is still controversial.

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Section: Future Perspectivementioning

confidence: 96%

Papillary Lesions of the Breast: A Review

González

Ibargüengoitia

Corona

et al. 2020

Breast Cancer Manag.

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“…A prior detailed subanalysis of these lesions found that complex sclerosing lesions were more likely to have washout kinetics and intraductal papillomas to have a larger proportion of cases with T2 hyperintense features. 12 In this study, we were unable to identify discriminating imaging characteristics of papillary and sclerosing lesions that reliably allow for differentiation from malignant entities. The clinical significance of increased detection of such papillary and sclerosing lesions, which are often considered “high-risk,” remains uncertain with differing outcomes and recommendations.…”

Section: Discussionmentioning

confidence: 82%

“…Prior reports describe the clinical management (and upgrade rates) of these lesions from portions of this patient cohort. 12 , 19 …”

Section: Discussionmentioning

confidence: 99%

Sixteen-Year Institutional Review of Magnetic Resonance Imaging–Guided Breast Biopsies: Trends in Histologic Diagnoses With Radiologic Correlation

Motanagh,

Dwan,

Azizgolshani

et al. 2023

Breast Cancer�(Auckl)

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Background: Breast magnetic resonance imaging (MRI) is an important imaging tool for the management of breast cancer patients and for screening women at high risk for breast cancer. Objectives: To examine long-term trends in the distribution of histologic diagnoses obtained from MRI-guided breast biopsies. Design: Retrospective analysis. Methods: We retrospectively reviewed the distribution of histologic diagnoses of MRI-guided breast biopsies from 2004 to 2019. All cases underwent central pathology review and lesions were classified based on the most prominent histologic finding present. Magnetic resonance imaging features were extracted from radiology reports when available and correlated with pathology diagnoses. Results: Four hundred ninety-four MRI-guided biopsies were performed on 440 patients; overall, 73% of biopsies were benign and 27% were malignant. The annual percentages of benign and malignant diagnoses remained similar throughout the 16-year period. Of the benign entities commonly identified, the percentage of benign papillary and sclerosing lesions detected in the benign biopsies increased significantly (13% in 2004-2011 vs 31% in 2012-2019, P = .03). The mean size of malignant lesions was larger than benign lesions (30.1 mm compared with 14.2 mm, P = .045); otherwise, there were no distinguishing radiologic features between benign and malignant lesions. Conclusion: The specificity of breast MRI remained constant over a 16-year period; however, there was a shift in the distribution of benign diagnoses with increased detection and biopsy of benign papillary and sclerosing lesions. Monitoring the distribution of breast MRI biopsy diagnoses over time with radiology-pathology correlation might improve the suboptimal specificity of breast MRI.

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Role of breast MRI in predicting histologic upgrade risks in high-risk breast lesions: A review

Kim

Chai

et al. 2021

European Journal of Radiology

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Papillary and sclerosing lesions of the breast detected and biopsied by MRI: Clinical management, upgrade rate, and association with apocrine metaplasia

Cited by 5 publications

References 25 publications

Papillary Lesions of the Breast: A Review

Papillary Lesions of the Breast: A Review

Sixteen-Year Institutional Review of Magnetic Resonance Imaging–Guided Breast Biopsies: Trends in Histologic Diagnoses With Radiologic Correlation

Role of breast MRI in predicting histologic upgrade risks in high-risk breast lesions: A review

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