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Chen P, Zhou D, Wang C, Ye G, Pan R, Zhu L. Treatment and Outcome of 341 Papillary Breast Lesions. World J Surg 2019; 43:2477-2482. [PMID: 31209512 DOI: 10.1007/s00268-019-05047-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Papillary breast lesions constitute a pathological heterogeneous group and display diverse clinical and imaging features. This study was conducted to analyze the upgrade rate of intraductal papilloma diagnosed on core needle biopsy and to assess the possible risk factors associated with upgrade to higher-risk lesions. We also examined the long-term outcomes in patients who received resection of the papillary lesions. MATERIALS AND METHODS The clinical and pathology records of 324 female patients who were diagnosed with papillary lesions based on core needle biopsy (CNB) from February 2010 to October 2016 at our institution were retrospectively analyzed. Patients were grouped by initial diagnosis into two groups (papilloma with or without atypia) and followed-up for long-term outcomes. For the upgrade to higher-risk lesions after excision, upgraded lesions were compared with benign papillomas for the collected variables. RESULTS A total of 341 lesions were included for final analysis, and all were available for follow-up. Papillomas with or without atypia diagnosed by CNB were found in 9 and 332 lesions, respectively. Papillomas without atypia on CNB were treated by open excision (n = 265) or vacuum-assisted biopsy (VAB) (n = 67), which yielded similar event-free rate (p = 0.19). The upgrade rate of this group to higher-risk lesions was 9.9%. Peripheral (p = 0.011) lesions in postmenopausal (p = 0.001) or older (p = 0.001) patients with papillomas without atypia based on CNB showed significantly higher upgrade rates. Papillomas with atypia on CNB were all managed by open excision, and concurrent malignancy was found in two lesions. CONCLUSION In conclusion, our results support benign papillary lesions based on CNB require further treatment. Peripheral lesions occurring in older or postmenopausal women are at higher risk for upgrade.
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Affiliation(s)
- Peixian Chen
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Dan Zhou
- Department of Breast Surgery, The First People's Hospital of Foshan, #81, North Lingnan Avenue, Chancheng, Foshan, Guangdong, People's Republic of China
| | - Chuan Wang
- The First People's Hospital of Foshan, #81, North Lingnan Avenue, Chancheng, Foshan, Guangdong, People's Republic of China
| | - Guolin Ye
- Department of Breast Surgery, The First People's Hospital of Foshan, #81, North Lingnan Avenue, Chancheng, Foshan, Guangdong, People's Republic of China.
| | - Ruilin Pan
- Department of Breast Surgery, The First People's Hospital of Foshan, #81, North Lingnan Avenue, Chancheng, Foshan, Guangdong, People's Republic of China
| | - Lewei Zhu
- Department of Breast Surgery, The First People's Hospital of Foshan, #81, North Lingnan Avenue, Chancheng, Foshan, Guangdong, People's Republic of China
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Kupsik M, Perez C, Bargaje A. Upstaging papillary lesions to carcinoma on surgical excision is not impacted by patient race. Breast Dis 2019; 38:67-72. [PMID: 30988233 DOI: 10.3233/bd-180379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The management of papillary lesions is controversial with studies showing different rates of upstaging to malignancy. There is a paucity of research into race as an independent risk factor. The aim of this study is to identify if race is correlated with upstaging to malignancy with a secondary focus of analyzing for other personal and tumor specific risk factors for upstaging. METHODS We performed a retrospective review of 123 papillary lesions with univariate analysis to identify risk factors for upstaging. RESULTS The incidence of papillary lesions found on core needle biopsy was 6%. Atypical papillary lesions were most likely to be upstaged to malignancy at a rate of 27.7%. Papillary lesions and papillary lesions with hyperplasia were also upstaged to cancer at a lower rate of 8.3% and 12.5%, respectively. A univariate analysis of all papillary lesions and a separate analysis of atypical lesions demonstrated a higher likelihood of upstage based on BIRADS classification. Race, age, size of tumor and other radiographic features were not associated with an increased risk for upstaging to malignancy. CONCLUSIONS Atypia remains the most significant contributor to the risk of upstaging papillary lesions to malignancy. Our research supports the practice of excising all atypical papillary lesions with selected excision of those without atypia. In our cohort, there was no association between race and risk of upstaging to malignacy.
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Affiliation(s)
- M Kupsik
- Division of Breast Surgical Oncology, Mercy Hospital and Medical Center, 2525 Michigan Avenue, Chicago, IL, USA
- University of Illinois, Metropolitan Group Hospitals, 836 W Wellington Ave, Chicago, IL, USA
| | - C Perez
- Division of Breast Surgical Oncology, Mercy Hospital and Medical Center, 2525 Michigan Avenue, Chicago, IL, USA
| | - A Bargaje
- Division of Surgical Pathology, Mercy Hospital and Medical Center, 2525 Michigan Avenue, Chicago, IL, USA
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Seely JM, Verma R, Kielar A, Smyth KR, Hack K, Taljaard M, Gravel D, Ellison E. Benign Papillomas of the Breast Diagnosed on Large-Gauge Vacuum Biopsy compared with 14 Gauge Core Needle Biopsy - Do they require surgical excision? Breast J 2016; 23:146-153. [DOI: 10.1111/tbj.12702] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jean M. Seely
- Department of Medical Imaging; The Ottawa Hospital; University of Ottawa; Ottawa Ontario Canada
| | - Raman Verma
- The Ottawa Hospital; Ottawa Ontario Canada
- University of Ottawa; Ottawa Ontario Canada
| | - Ania Kielar
- The Ottawa Hospital; Ottawa Ontario Canada
- University of Ottawa; Ottawa Ontario Canada
- Royal Victoria Hospital; Barrie Ontario Canada
| | - Karl R. Smyth
- The Ottawa Hospital; Ottawa Ontario Canada
- University of Ottawa; Ottawa Ontario Canada
| | | | - Monica Taljaard
- Clinical Epidemiology Program; Ottawa Hospital Research Institute; Ottawa Ontario Canada
- Department of Epidemiology and Community Medicine; University of Ottawa; Ottawa Ontario Canada
| | - Denis Gravel
- Department of Pathology; The Ottawa Hospital; Ottawa Ontario Canada
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Wyss P, Varga Z, Rössle M, Rageth CJ. Papillary lesions of the breast: outcomes of 156 patients managed without excisional biopsy. Breast J 2014; 20:394-401. [PMID: 24861903 DOI: 10.1111/tbj.12283] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Papillomas of the breast are benign epithelial neoplasms. Because of the low, but continued potential for malignancy, the treatment options after initial diagnosis remain controversial. The aim of this study was to analyze the clinical course of patients with papilloma who were managed by active surveillance following initial diagnosis by core needle biopsy or vacuum-assisted biopsy. This retrospective study analyzed 174 patients with 180 papillomas that were diagnosed by core needle biopsy (113 cases) or vacuum-assisted biopsy (67 cases) at the Breast Center Seefeld Zurich between February 2002 and May 2011. We excluded 24 cases that underwent excisional biopsy for removal of the lesion. Over a mean follow-up of 3.5 years, 13 further events occurred in 156 cases (8%). These events included two cases of ductal carcinoma in situ (one after 4 and one after 6 years), one case of atypical ductal hyperplasia, one radial scar, eight cases of papilloma, and one case of flat epithelial atypia. No invasive carcinomas occurred during the follow-up period. Conservative management of 156 papillary lesions with removal by vacuum-assisted biopsy and surveillance was not associated with invasive cancer over a median follow-up of 3.5 years. Therefore, this approach seems to be a safe option for the clinical management of papillary lesions.
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Abstract
The indications, technique, results and limitations of MRI vacuum-assisted breast biopsies are discussed from a review of the literature. This was initially a home-grown technique and its development was slowed down by several factors. As a result of major technical advances, it has become a reliable and very consistent procedure with a low rate of underestimation. It is now an undisputed technique when suspicious MRI enhancement is seen with no corresponding mammography or ultrasound features.
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Affiliation(s)
- R Plantade
- Nice Europe Imaging Centre, 15, rue Alberti, 06000 Nice, France.
| | - I Thomassin-Naggara
- Department of Radiology, Tenon Hospital, Paris Public Hospitals Health Service (AP-HP), Pierre et Marie Curie University Oncology Institute, 4, rue de la Chine, 75020 Paris, France
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7
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Can additional immunohistochemistry staining replace the surgical excision for the diagnosis of papillary breast lesions classified as benign on 14-gage core needle biopsy? Breast Cancer Res Treat 2013; 137:797-806. [DOI: 10.1007/s10549-012-2403-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 12/24/2012] [Indexed: 10/27/2022]
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8
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Al Hassan T, Delli Fraine P, El-Khoury M, Joseph L, Zheng J, Mesurolle B. Accuracy of percutaneous core needle biopsy in diagnosing papillary breast lesions and potential impact of sonographic features on their management. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:1-9. [PMID: 22987609 DOI: 10.1002/jcu.21993] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 08/13/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To assess retrospectively the accuracy of core needle biopsy in diagnosing papillary breast lesions and evaluate the prediction of malignant papillary lesions based on sonographic features. METHODS Review of 130 papillary lesions diagnosed on core needle biopsy (2002-2008) in 110 patients. The biopsy results were compared with final surgical pathology or evolution on imaging follow-up. Lesion size, patient age, type of biopsy needle and guidance, and length of imaging follow-up were documented. Sonographic features were retrospectively reviewed according to the BI-RADS lexicon. Morphology, not part of BI-RADS, was assessed as intraductal, intracystic, or solid. RESULTS Of the 130 papillary lesions, 6 were sampled with an 11-G vacuum-assisted needle under stereotactic guidance and the remaining 124 were sampled under US guidance with a 14-G (n = 115), 18-G (n = 8), or 10-G (n = 1) needle. Initial core needle biopsy diagnosis was benign (n = 103), showed atypia (n = 20), or malignancy (n = 7). Thirty-seven (36%) benign lesions were surgically excised and 66 (64%) were followed up. On final outcome, 10 benign lesions were upgraded to malignancy (9.7%) and 3 to atypia (3.6%). There was no significant difference in the benign, malignant, and upgraded groups with respect to size, age, or BI-RADS sonographic characteristics. None of the oval-shaped lesions nor the intraductal ones were upgraded. CONCLUSIONS Although some sonographic features could favor a benign diagnosis, when a core biopsy yields the diagnosis of a papillary lesion, surgical excision is recommended to definitely exclude malignancy.
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Affiliation(s)
- Tasneem Al Hassan
- Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, Montreal, Quebec, H3H 1A1, Canada
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9
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Holley SO, Appleton CM, Farria DM, Reichert VC, Warrick J, Allred DC, Monsees BS. Pathologic outcomes of nonmalignant papillary breast lesions diagnosed at imaging-guided core needle biopsy. Radiology 2012; 265:379-84. [PMID: 22952379 DOI: 10.1148/radiol.12111926] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the upstage rate from nonmalignant papillary breast lesions obtained at imaging-guided core needle biopsy (CNB) and if there are any clinical, imaging, or pathologic features that can be used to predict eventual upstaging to malignancy. MATERIALS AND METHODS This retrospective case review was institutional review board approved and HIPAA compliant, with a waiver of informed consent. A database search (from January 2001 to March 2010) was performed to find patients with a nonmalignant papillary breast lesion diagnosed at CNB. Of the resulting 128 patients, 86 (67%) underwent surgical excision; 42 (33%) patients were observed with imaging, for a median observation time of 4.1 years (range, 1.0-8.6 years). Chart review was performed to determine pertinent features of each case. RESULTS Fourteen of 128 patients were subsequently found to have malignancy at excision, for an upstage rate of 11%. Nine (7%) of the 128 patients were subsequently found to have atypia at excision. Comparisons between patients with upstaged lesions and patients whose lesions were not upstaged demonstrated patients with upstaged lesions to be slightly older (65 vs 56 years, P=.01), more likely to have a mass than calcifications at imaging (P=.03), and to have had less tissue obtained at biopsy (three vs five cores obtained, P=.02; 14- vs 9-gauge needle used, P<.01; no vacuum assistance used, P<.01). Most strongly predictive of eventual malignancy, however, was whether the interpreting pathologist qualified the benign diagnosis at CNB with additional commentary (P<.01). CONCLUSION Given the substantial upstage rate (11%) of papillary lesions diagnosed at imaging-guided CNB, surgical excision is an appropriate management decision; however, careful evaluation in concert with an expert breast pathologist may allow for observation in appropriately selected patients.
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Affiliation(s)
- Susan O Holley
- Breast Imaging Division, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110, USA.
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Surgical excision of benign papillomas diagnosed with core biopsy: a community hospital approach. Radiol Res Pract 2011; 2011:679864. [PMID: 22191029 PMCID: PMC3236350 DOI: 10.1155/2011/679864] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 10/05/2011] [Indexed: 11/17/2022] Open
Abstract
Our goal was to assess the value of surgical excision of benign papillomas of the breast diagnosed on percutaneous core biopsy by determining the frequency of upgrade to malignancies and high risk lesions on a final surgical pathology. We reviewed 67 patients who had biopsies yielding benign papilloma and underwent subsequent surgical excision. Surgical pathology of the excised lesions was compared with initial core biopsy pathology results. 54 patients had concordant benign core and excisional pathology. Cancer (ductal carcinoma in situ and invasive ductal carcinoma) was diagnosed in five (7%) patients. Surgery revealed high-risk lesions in 8 (12%) patients, including atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ. Cancer and high risk lesions accounted for 13 (19%) upstaging events from benign papilloma diagnosis. Our data suggests that surgical excision is warranted with core pathology of benign papilloma.
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Tokiniwa H, Horiguchi J, Takata D, Kikuchi M, Rokutanda N, Nagaoka R, Sato A, Odawara H, Tozuka K, Oyama T, Takeyoshi I. Papillary lesions of the breast diagnosed using core needle biopsies. Exp Ther Med 2011; 2:1069-1072. [PMID: 22977622 DOI: 10.3892/etm.2011.332] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 07/04/2011] [Indexed: 11/06/2022] Open
Abstract
Papillary lesions of the breast include a broad spectrum of lesions, from benign papillomas to papillary carcinomas. It is difficult to determine whether a lesion is benign or malignant based on the fragmented material of a core needle biopsy (CNB). This study evaluated patients with papillary lesions examined using CNB. We retrospectively reviewed 31 papillary lesions diagnosed using CNB between 2004 and 2007. The clinical findings of benign and malignant papillary lesions were compared. The average patient age was 48.9 years. Twelve patients presented with a discharge and 10 patients presented with a lump. Eight patients were asymptomatic. The initial diagnoses by CNB of the 31 lesions were 25 intraductal papillomas, 4 intracystic papillomas and 2 adenomas. After CNB, excisional biopsies were performed in 23 patients and biopsies with a Mammotome(®) in 2 patients. Seven patients underwent regular follow-up. Five (16%) of the 31 patients with papillary lesions were ultimately diagnosed with breast cancer. The average distance from the nipple to a tumor diagnosed as malignant was 2.46 cm, which was longer than for a tumor diagnosed as benign. Ultimately, 5 papillary lesions (16%) were diagnosed as breast cancer. To avoid overlooking a malignancy, surgical excision is advantageous for papillary lesions, particularly those located far from the nipple.
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12
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Kim M, Kim SI, Youk J, Moon H, Kwak J, Park BW, Kim EK. The diagnosis of non-malignant papillary lesions of the breast: comparison of ultrasound-guided automated gun biopsy and vacuum-assisted removal. Clin Radiol 2011; 66:530-5. [DOI: 10.1016/j.crad.2011.01.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 12/23/2010] [Accepted: 01/10/2011] [Indexed: 11/26/2022]
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Abstract
BACKGROUND This study was designed to evaluate the clinical and pathologic parameters of benign papillomas diagnosed on core needle biopsy (CNB) and predict malignancy risk after surgical excision. METHODS We retrospectively reviewed clinicopathologic findings for 160 CNB-diagnosed benign papillomas followed by surgical excision from 154 patients. RESULTS Ten (6.3%) of the excised lesions were diagnosed as malignant. Univariate analysis showed that those that were palpable on physical examination, detected as a mass on mammography, or >1 cm on sonography were significantly associated with malignancy. In multivariate analysis, lesions that were palpable (odds ratio (OR), 29.2; 95% confidence interval (CI), 4.06-209.58; P = 0.001) or detected as a mass (OR, 5.68; 95% CI 1.08-29.87; P = 0.04) remained significantly associated with malignancy. In a CART analysis, including all variables, lesions that were palpable and associated with a mass on mammogram were confirmed as malignant. CONCLUSIONS Breast lesions diagnosed as benign papillomas on CNB had a 6.3% risk of being malignant. The risk was highest for lesions that were palpable and detectable as a mass on a mammogram. In addition, the low-risk patients avoid immediate surgical excision, although they should be followed carefully.
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Kil WH, Cho EY, Kim JH, Nam SJ, Yang JH. Is surgical excision necessary in benign papillary lesions initially diagnosed at core biopsy? Breast 2008; 17:258-62. [DOI: 10.1016/j.breast.2007.10.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 09/26/2007] [Accepted: 10/11/2007] [Indexed: 10/22/2022] Open
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Skandarajah AR, Field L, Yuen Larn Mou A, Buchanan M, Evans J, Hart S, Mann GB. Benign Papilloma on Core Biopsy Requires Surgical Excision. Ann Surg Oncol 2008; 15:2272-7. [DOI: 10.1245/s10434-008-9962-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Revised: 04/22/2008] [Accepted: 04/22/2008] [Indexed: 11/18/2022]
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Nonmalignant papillary lesions of the breast at US-guided directional vacuum-assisted removal: a preliminary report. Eur Radiol 2008; 18:1774-83. [DOI: 10.1007/s00330-008-0960-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Revised: 02/28/2008] [Accepted: 03/02/2008] [Indexed: 10/22/2022]
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17
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García MJ, Alvarez M, Santos AL, Raya JL, Fuentes E, Bascuñana G. [Core needle biopsy of papillary breast lesions: impact on patient management]. RADIOLOGIA 2008; 50:131-9. [PMID: 18367061 DOI: 10.1016/s0033-8338(08)71946-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the clinical and radiological presentations of papillary breast lesions and to evaluate the performance of core needle breast biopsy in papillary lesions. MATERIAL AND METHODS We retrospectively studied 55 papillary breast lesions in 46 patients aged 28 to 87 years diagnosed using core needle biopsy in the period 1994-2005. We reviewed the clinical and radiological presentations of the lesions, the findings at histological study after percutaneous biopsy, and the correlation of these findings with those of the surgical biopsy (44 cases) and/or radiological follow-up (42 cases). RESULTS The most common mammographic presentation was circumscribed or ill-defined, single or multiple nodules. Ill-defined lesions were significantly associated with malignancy (p < 0.05). The results of the percutaneous biopsy were: benign papillary lesion (n = 32), papillary lesion with atypia (n = 9), and malignant papillary lesion (n = 14). The diagnostic accuracy of core needle biopsy calculated from the 44 cases with surgical confirmation was: sensitivity 63%, specificity 100%, predictive positive value 100%, predictive negative value 73%, and rate of underestimation 25%. During follow-up, increased lesion size or the appearance of new lesions was seen in four patients. CONCLUSIONS The diagnosis can be suspected in cases of postmenopausal patients with multiple circumscribed or ill-defined, solid or mixed lesions at ultrasound study. Although the finding of an invasive malignant papillary lesion after percutaneous biopsy enables treatment to be planned, in the remaining situations (benign papillary lesion, with atypia, or carcinoma in situ) underestimation is common and the lesion should be surgically excised. Vacuum-assisted biopsy systems might improve these results.
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Affiliation(s)
- M J García
- Servicio de Radiodiagnóstico, Hospital Universitario Reina Sofía, Córdoba, España.
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Tourasse C, Sebag P, Dénier J, Rouyer N, Donné C. Valeur des macrobiopsies mammaires sous guidage stéréotaxique en cas de découverte d’unehyperplasie canalaire atypique. ACTA ACUST UNITED AC 2008; 89:40-6. [DOI: 10.1016/s0221-0363(08)70368-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bonaventure T, Cormier B, Lebas P, Bonneau C, Michenet P. [Benign papilloma: is US-guided vacuum-assisted breast biopsy an alternative to surgical biopsy?]. ACTA ACUST UNITED AC 2007; 88:1165-8. [PMID: 17878878 DOI: 10.1016/s0221-0363(07)89928-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this study is to assess the value of US guided vacuum-assisted breast biopsy compared to surgery for management of intraductal papilloma. This retrospective study included 13 patients with hypoechoic nodular lesion corresponding to small benign intraductal papillomas on biopsy and visible by US. The lesions were removed using US-guided vacuum-assisted biopsy and all tissue material was reviewed at histology. The mean size of papillomas was 9.3 mm (5-16 mm). Vacuum-assisted tumor removal was considered total for all 13 lesions. Maximum follow-up was 57 months. Two patients had tumor recurrence at 22 and 28 months respectively. In one case, atypical ductal hyperplasia was present at the periphery of the papilloma, requiring complementary surgery. US-guided vacuum-assisted excision of small benign tumors such as solitary intraductal papillomas appears to be an alternative to surgical biopsy. Because of the large volume of tissue removed, total tumor excision is possible allowing detection of incidental associated lesions.
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Affiliation(s)
- T Bonaventure
- Service de Gynécologie-Obstétrique, Hôpital Porte-Madeleine, CHR d'Orléans, BP 2439, 45032 Orléans Cedex 1
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Roger P. [Breast macrobiopsy: the need for standardized terminology]. ACTA ACUST UNITED AC 2006; 87:263-4. [PMID: 16550109 DOI: 10.1016/s0221-0363(06)73999-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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