Breast Papillomas in the Era of Percutaneous Needle Biopsy

Sohn, Vance Y.; Keylock, Joren; Arthurs, Zachary M.; Wilson, A.R.M.; Herbert, Garth S.; Perry, Jason R.; Eckert, Matthew J.; Smith, D.L.; Groo, Stephen; Brown, Tommy A.

doi:10.1245/s10434-007-9470-0

Cited by 73 publications

(55 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, other researchers have supported selective excision in cases of atypia or in the presence of risk factors. [2][3][4]9,[13][14][15][16]18,[29][30][31][32][33] Table 4 shows the published data on papillomas confirmed by core needle biopsy and subsequent surgical excision and their upgrade rates to malignancy. These studies reported their rates of upgrade from benignity on core needle biopsy to malignancy and papilloma with atypia after surgical excision.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…3 However, there have been a number of controversies regarding management with subsequent surgical excision in benign papillomas without atypia after core needle biopsy. 1,2,[4][5][6][7][8][9][10][11][12] Some recent investigators have suggested the use of selective surgical excision for benign papillomas without atypia after considering clinical and radiologic factors or supported conservative management. 4,7,[13][14][15][16][17][18] Prediction of clinical and radiologic factors associated with an upgrade to atypia or malignancy will be very helpful for both clinicians and radiologists.…”

mentioning

confidence: 99%

See 2 more Smart Citations

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

Sohn

2013

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

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

Sohn

2013

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

“…The published literature reports upgrade rates to carcinoma following a diagnosis of benign papilloma at CNB ranging from 0% to 29% [1][2][3]. Some authors believe that benign papillomas diagnosed at CNB with imaging concordance may be safely managed with clinical and imaging follow-up [6,7,[12][13][14][15][16][17][18][19][20]. Others advocate surgical excision to exclude any associated malignancy [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy

et al. 2015

View full text Add to dashboard Cite

“…Reported upgrading rates from benign papillary lesions diagnosed by CNB to malignant papillary lesions diagnosed on subsequent surgical excision range from 0% to 29% (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Some investigators have suggested that benign papillary lesions without atypia diagnosed by CNB, in combination with concordant imaging findings, can be safely followed without further surgery (2-7).…”

mentioning

confidence: 99%

Upgrading rate of papillary breast lesions diagnosed by core-needle biopsy

Wiratkapun

Keeratitragoon²,

Lertsithichai³

et al. 2013

Diagn Interv Radiol

View full text Add to dashboard Cite

ORIGINAL ARTICLE PURPOSE We aimed to estimate the upgrading rate of core-needle biopsy (CNB)-diagnosed papillary breast lesions to atypical or malignant papillary lesions on subsequent surgery. MATERIALS AND METHODSWe performed a retrospective review of medical records and imaging findings of patients diagnosed by CNB as having papillary lesions from January 1, 2005 to May 31, 2011. Outcomes were determined by pathology findings from surgical excision or by imaging findings at 12 months follow-up. RESULTSOf 130 papillary lesions in 127 patients, the upgrading rates were 0% for benign papillary lesion to malignancy, 19% for benign papillary lesion to atypical papillary lesion, and 31% for atypical lesion to malignancy. Most of the malignancies were ductal carcinoma in situ. The presence of malignant lesions was related to specific symptoms (palpable mass or nipple discharge; P = 0.020) and to a higher Breast Imaging Reporting and Data System (BIRADS) category (P = 0.017). CONCLUSION CNB is accurate in the diagnosis of benign papillary lesions. If no atypical cells are present, no malignancy is found. The presence of atypia on CNB strongly indicates a need for surgical excision.

show abstract

Breast Papillomas in the Era of Percutaneous Needle Biopsy

Abstract: Benign breast papillomas diagnosed by CNB have a low risk of malignancy and do not need excision. However, they should be considered high risk lesions which require serial radiographic monitoring. Papillomas associated with atypia or malignancy should continue to be excised.

Cited by 73 publications

References 26 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

Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy

Upgrading rate of papillary breast lesions diagnosed by core-needle biopsy

Contact Info

Product

Resources

About