Risk Factors Associated with Conversion from Nonmalignant to Malignant Diagnosis After Surgical Excision of Breast Papillary Lesions

Cheng, Tsung-Yen; Chen, Chii‐Ming; Lee, Ming-Yuan; Lin, Kwang-Jane; Hung, Cheng-Fung; Yang, Po-Sheng; Yu, Ben-Long; Yang, Chen-En; Tsai, Tzu-Jung; Lin, Chung-Wei

doi:10.1245/s10434-009-0637-8

Cited by 45 publications

(30 citation statements)

References 16 publications

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“…In a cohort study by Cheng et al [16], 9.21% of preoperative nonmalignant papillary lesions were converted to malignant diagnosis after surgery. Atypical lesions and patients aged 45 years or older were significant factors associated with such conversion.…”

Section: Discussionmentioning

confidence: 99%

Role of Some Risk Factors in the Etiology of Breast Cancer in the Sudan

Ahmed¹,

Musa²,

Eltybe³

et al. 2014

TOBCANJ

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Abstract:Aim: The aim of this study was to correlate breast cancer by common breast cancer risk factors in the Sudan.Methodology: Using a purposeful questionnaire 150 female breast cancer patients and 100 apparently health controls were asked detailed information on about risk factors.Results: Out of the 150 women with breast cancer, 38 (25.3%), 22(14.7%), 26(17.3%), 20(13.3%), 21(14%), 11(7.3%), 72(48%), and 86(57.3%) were identified as having a previous history of oral contraceptives usage, a family history of breast cancer, a past history of benign breast disease, a previous history of breast cancer, a previous breast biopsy, claimed other cancers in their families, confessed a pesticides exposure, and over weigh in most of their lives respectively. Out of the 150 women, 44(29.3%) were found to have a previous physical activity. Moreover, 44.8% and 66.9% have attended the menarge at the age of 13 and 14 respectively. Of these factors, statistical significant risks were found with, past history of benign breast disease (P < 0.04), previous breast biopsies (P <0.07), pesticides and plasticizers exposure (P < 0.01 and 0.04), period of being over weight (P <0.001), practice physical activities (P <0.0001), unmarried (P <0.002), decreased number of children (P <0.002). According to the ethnic group, Gaalyaeen tribes represented 61(40.7%) of the study subjects. Most of the patients were from Khartoum state, constituting 37.3%. Conclusion:There was variable exposure to many risk factors for breast cancer in the Sudan. The study suggests further separate measurement of risk factors for breast cancer, as well as, factors that might reduce those risk factors. Cohort mean of evaluation is highly recommended.

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Section: Discussionmentioning

confidence: 99%

Role of Some Risk Factors in the Etiology of Breast Cancer in the Sudan

Ahmed¹,

Musa²,

Eltybe³

et al. 2014

TOBCANJ

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“…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%

“…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.…”

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confidence: 99%

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

Sohn

2013

Journal of Ultrasound in Medicine

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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.

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“…Moreover in some studies [9,12,14,32,33,35,45] guidance method, type of CB and needle gauge were not specified.…”

Section: Papillary Lesions With Epithelial Atypiamentioning

confidence: 99%

Non-Malignant Breast Papillary Lesions - B3 Diagnosed on Ultrasound - Guided 14-Gauge Needle Core Biopsy: Analysis of 114 Cases from a Single Institution and Review of the Literature

Bianchi

Bendinelli

Saladino

et al. 2015

Pathol. Oncol. Res.

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One-hundred-fourteen consecutive cases of breast ultrasound-guided 14-gauge needle core biopsy (14G NCB) performed from January 2001 to June 2013 and diagnosed as non-malignant papillary lesion (PL)-B3, were reviewed and compared with definitive histological diagnosis on surgical excision (SE) to evaluate the diagnostic accuracy of ultrasound-guided 14G NCB. PL with epithelial atypia on 14G NCB were associated to malignancy on definitive histological diagnosis on SE in 22 (7 DCIS and 15 invasive carcinomas) of 46 cases with an underestimation rate of 47.8 %, while 9 (4 DCIS and 5 invasive carcinomas) cases out of 68 cases of PL without epithelial atypia were upgraded to carcinoma with an underestimation rate of 13.2 %. In cases of PL with epithelial atypia on ultrasound-guided 14G NCB, SE appears mandatory due to the high risk of associated malignancy. The diagnosis of PL without epithelial atypia on ultrasound-guided 14G NCB does not exclude malignancy at subsequent SE, consequently further assessment (by surgical or vacuum-assisted excision) is recommended to avoid the risk of delaying a diagnosis of malignancy, although this tends to be lower (1 in 8 patients).

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Risk Factors Associated with Conversion from Nonmalignant to Malignant Diagnosis After Surgical Excision of Breast Papillary Lesions

Cited by 45 publications

References 16 publications

Role of Some Risk Factors in the Etiology of Breast Cancer in the Sudan

Role of Some Risk Factors in the Etiology of Breast Cancer in the Sudan

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

Non-Malignant Breast Papillary Lesions - B3 Diagnosed on Ultrasound - Guided 14-Gauge Needle Core Biopsy: Analysis of 114 Cases from a Single Institution and Review of the Literature

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