Vacuum-assisted complete excision of solid intraductal/intracystic masses and complex cysts: Is follow-up necessary?

Quinn-Laurin, Vanessa; Hogue, Jean-Charles; Pinault, Sylvie; Duchesne, Nathalie

doi:10.1016/j.breast.2017.06.014

Cited by 4 publications

(5 citation statements)

References 34 publications

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“…Complex solid cystic masses, when completely excised with ultrasound guided vaccumm assisted biopsy and proven to be benign on histopathological examination, do not require any further imaging follow up or surgery. 16 Complex solid cystic masses also showed features of apocrine metaplasia, cyst formation, and epithelial hyperplasia without atypia (epitheliosis). Solid lesions were commonly sclerosing adenosis.…”

Section: Discussionmentioning

confidence: 99%

Imaging and Pathological Correlation in Spectrum of Fibrocystic Breast Disease and its Mimics – our Experience

et al. 2022

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Background: Fibrocystic change (FCC) of the breast is one of the most common benign breast diseases commonly observed between 20-50 years, with a peak in the perimenopausal age group. Patients present with various symptoms such as lump in the breast, mastalgia (commonly related to the menstrual cycles) or nipple discharge. Materials and Methods: In our retrospective study, which included 172 patients, the imaging findings were observed by ultrasound and X-ray mammogram. Based on the Breast Imaging Reporting and Data System (BI-RADS) guidelines given by the American college of Radiology (ACR), our imaging findings were classified as BI-RADS 2 in benign lesions, complicated cysts were classified as probably benign - BI-RADS 3. Indeterminate findings were classified as suspicious lesions and BI-RADS 4a/b/c. Imaging and histopathological correlation was performed. Results: Ultrasound findings revealed diffuse/ bilateral abnormalities with the most common finding being simple cysts followed in descending order by complicated cysts, clustered cysts, complex solid cystic masses, solid lesions, duct ectasia, and intraductal lesions. Mammogram showed dense (type C or D) fibro glandular pattern obscuring the lesions, followed by well-defined / partly obscured opacities. Simple cysts and complicated cysts showed predominant features of cyst formation on HPE. Atypical hyperplasia was seen in ductal and complex solid cystic mass lesions. Conclusion: It is essential for radiologists to be familiar with imaging and pathological findings of fibrocystic disease of the breast for further workup and management.

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Section: Discussionmentioning

confidence: 99%

Imaging and Pathological Correlation in Spectrum of Fibrocystic Breast Disease and its Mimics – our Experience

et al. 2022

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“…If the lesion is determined to be benign and concordant with imaging, follow up with clinical breast exams and possible breast imaging studies at 6-or 12-month intervals can be performed to ensure two-year stability of the lesion [5]. In addition to core needle and surgical biopsy, a vacuumassisted complete excision of the complex solid and cystic mass is sometimes performed for definitive treatment [6].…”

Section: Discussionmentioning

confidence: 99%

“…If the lesion in question is categorized as BIRADS 4 or 5, a core needle biopsy should be performed as it allows for a definitive diagnosis more often than fine-needle aspiration [13]. If a cystic component is present, vacuum assisted core needle biopsy may be preferred [6]. The American Society of Clinical Oncology/College of American Pathologists recommend routine testing of newly diagnosed invasive breast cancer for ER/PR/HER2 receptor expression [14].…”

Section: Invasive Ductal Carcinomamentioning

confidence: 99%

Complex Solid and Cystic Breast Cancer: A Series of Six Case Reports

Mehta¹,

Rousslang²,

Shokouh-Amiri³

et al. 2020

Radiology Case

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A cyst in the breast containing a thick wall, internal septations, or a solid intracystic component is defined as a complex solid and cystic breast mass. These lesions carry a malignant potential between 23-31% and thus require further evaluation with biopsy [1]. We report six cases in which patients were found to have a complex solid and cystic mass, all of which were proven to be malignant breast cancers of varying etiologies. We also review the literature on malignant etiologies of complex solid and cystic breast masses, including their clinical presentation, work-up, histopathologic and immunochemistry findings, treatment, and prognosis.

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“…These recommendations provide the basis for minimally invasive treatment of this disease, with 6-month follow-up intervals recommended in the guidelines [23]. There have been an increasing number of reports on the effectiveness of US-guided or mammographyguided (stereotactic) VAB in treating IDP of the breast with no clinical or pathological signs of increased risk for malignant transformation [6,24,25]. Further clinical observation after biopsy shows a recurrence rate of 0-15.4% [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…There have been an increasing number of reports on the effectiveness of US-guided or mammographyguided (stereotactic) VAB in treating IDP of the breast with no clinical or pathological signs of increased risk for malignant transformation [6,24,25]. Further clinical observation after biopsy shows a recurrence rate of 0-15.4% [25][26][27]. A recent large series including 1578 patients, with a median follow-up of 34 months in those with benign papilloma, reported a recurrence rate of 4.4% after VAB [27].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided percutaneous microwave ablation of central intraductal papilloma: a prospective pilot study

Meng

et al. 2019

International Journal of Hyperthermia

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Background: Central intraductal papilloma (IDP) has a low risk of cancer evolution; therefore, surgical treatment of IDP is controversial. We sought to validate ultrasound (US)-guided percutaneous microwave ablation (MWA) for minimally invasive treatment of IDP. Methods: Thirteen women with central IDP, including six with nipple discharge, underwent US-guided core needle biopsy and MWA from December 2016 to November 2017. Lesions histologically diagnosed as benign IDP were included. The hydro-dissection technique was used to protect the nipple during the entire ablation procedure. We evaluated and recorded data of complete ablation, volume reduction, and complications. Results: MWA was successfully performed in all patients, with 100% complete ablation, assessed by magnetic resonance imaging or contrast-enhanced US. Mean tumor size was 13.5 ± 4.1 (7.0-20.0) mm; the mean ablation time was 1.4 (0.7-10.3) min. At the median 13.7-month follow-up, mean lesion sizes at 3, 6, and 12 months after MWA were all significantly smaller than that at baseline. Total volume reduction rates were 52.3 ± 18.2% (range, 24.2-81.8%), 72.6 ± 23.1% (range, 39.4-95.9%), and 92.9 ± 7.5% (range, 75.0-100%) at 3-, 6-, and 12-month follow-up, respectively, with significant differences (p < .01). Three lesions with diameters 7 mm, 9 mm, and 12 mm disappeared completely at 3, 6, and 6 months after MWA, respectively, on US imaging. Nipple discharge disappeared immediately after MWA. Cosmetic effects were reported as excellent by all patients and no complications were observed. Conclusion: US-guided MWA of central IDP proved feasible and effective, with considerable volume reduction and satisfactory cosmetic outcomes.

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Vacuum-assisted complete excision of solid intraductal/intracystic masses and complex cysts: Is follow-up necessary?

Cited by 4 publications

References 34 publications

Imaging and Pathological Correlation in Spectrum of Fibrocystic Breast Disease and its Mimics – our Experience

Imaging and Pathological Correlation in Spectrum of Fibrocystic Breast Disease and its Mimics – our Experience

Complex Solid and Cystic Breast Cancer: A Series of Six Case Reports

Ultrasound-guided percutaneous microwave ablation of central intraductal papilloma: a prospective pilot study

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