Papillary Tumors of the Breast: US Findings of the Benign and Malignant Lesions

Abstract

Purpose: To determine which sonographic findings usefully differentiate between benign and malignant papillary tumors. Materials and Methods: We retrospectively rev i ewed the ultrasonographic findings of 42 surgically proven cases of papillary breast lesions [11 malignant lesions (7 inva s i ve papillary carcinomas, 4 intraductal papillary carcinomas) and 31 benign intraductal papillomas]. All 42 cases were classified sonographically as cystic or ductal, or solid type, and the shape, wall change, margin, internal echo-pattern, posterior echo change and other associated findings for the two types were then analysed.

Sonographic Differentiation of Benign and Malignant Papillary Lesions of the Breast

“…In contrast to the result of Lam et al, 6 posterior acoustic enhancement was a characteristic finding of malignant papillary lesions in our study. This result is similar to that of Lee et al 5 They reported that solid papillary carcinomas were frequently associated with mucin production, which was not found in benign papillomas, and that might be why posterior enhancement was a characteristic finding of papillary carcinomas. 5 There is controversy over treatment of papillary neoplasms.…”

“…This result is similar to that of Lee et al 5 They reported that solid papillary carcinomas were frequently associated with mucin production, which was not found in benign papillomas, and that might be why posterior enhancement was a characteristic finding of papillary carcinomas. 5 There is controversy over treatment of papillary neoplasms. Some have reported that papillary lesions diagnosed as benign on core needle biopsy should be surgically excised because of a histologic upgrade at excision and a relatively low negative predictive value (83%).…”

Role of Sonography in the Differentiation of Benign, High‐Risk, and Malignant Papillary Lesions of the Breast

“…Most of our cancers and high‐risk lesions showed posterior features of enhancement or shadowing, whereas most of the benign papillomas had no associated posterior features. Unlike the study by Lee et al, 10 7 (15.2%) benign papillomas in the study by Kim et al 9 and 6 (26.1%) benign papillomas in our study had the posterior feature of acoustic enhancement. In addition, our results support the data of Kim et al 9 in that none of the benign papillomas had the posterior feature of shadowing.…”

“…In a study by Lee et al, 10 they demonstrated that in solid papillary lesions, posterior enhancement was more frequently seen in papillary cancers. The study by Kim et al 9 supported that finding by reporting that posterior acoustic enhancement was a significant ( P < .05) finding in papillary cancers.…”

“…Very few published articles exist regarding the sonographic findings between papillary lesions of the breast 7 , 9 , 10 . Thus, the purpose of our study was to evaluate the sonographic features of benign, high‐risk, and malignant papillary breast lesions in an academic medical center.…”