TY - JOUR
T1 - Benign papillomas without atypia diagnosed on core needle biopsy
T2 - Experience from a single institution and proposed criteria for excision
AU - Nayak, Anupma
AU - Carkaci, Selin
AU - Gilcrease, Michael Z.
AU - Liu, Ping
AU - Middleton, Lavinia P.
AU - Bassett, Roland L.
AU - Zhang, Jinxia
AU - Zhang, Hong
AU - Coyne, Robin L.
AU - Bevers, Therese B.
AU - Sneige, Nour
AU - Huo, Lei
N1 - Funding Information:
The authors would like to thank Kim-Anh Vu for excellent assistance on the figures and Ariana Trevino and Kelly Phan for their clerical support. This work is supported in part by the institutional start-up funds to LH from MD Anderson Cancer Center.
PY - 2013/12
Y1 - 2013/12
N2 - Background The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. In this study, we determined the upgrade rate to malignancy for BPs without atypia diagnosed on CNB and whether there are factors associated with upgrade. Methods Through our pathology database search, we studied 80 BPs without atypia identified on CNB from 80 patients from 1997 to 2010, including 30 lesions that had undergone excision and 50 lesions that had undergone ≥ 2 years of radiologic follow-up. Associations between surgery or upgrade to malignancy and clinical, radiologic, and pathologic features were analyzed. Results Mass lesions, lesions sampled by ultrasound-guided CNB, and palpable lesions were associated with surgical excision. All 3 upgraded cases were mass lesions sampled by ultrasound-guided CNB. None of the lesions with radiologic follow-up only were upgraded to malignancy. The overall upgrade rate was 3.8%. None of the clinical, radiologic, or histologic features were predictive of upgrade. Conclusion Because the majority of patients can be safely managed with radiologic surveillance, a selective approach for surgical excision is recommended. Our proposed criteria for excision include pathologic/radiologic discordance or sampling by ultrasound-guided CNB without vacuum assistance when the patient is symptomatic or lesion size is ≥ 1.5 cm.
AB - Background The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. In this study, we determined the upgrade rate to malignancy for BPs without atypia diagnosed on CNB and whether there are factors associated with upgrade. Methods Through our pathology database search, we studied 80 BPs without atypia identified on CNB from 80 patients from 1997 to 2010, including 30 lesions that had undergone excision and 50 lesions that had undergone ≥ 2 years of radiologic follow-up. Associations between surgery or upgrade to malignancy and clinical, radiologic, and pathologic features were analyzed. Results Mass lesions, lesions sampled by ultrasound-guided CNB, and palpable lesions were associated with surgical excision. All 3 upgraded cases were mass lesions sampled by ultrasound-guided CNB. None of the lesions with radiologic follow-up only were upgraded to malignancy. The overall upgrade rate was 3.8%. None of the clinical, radiologic, or histologic features were predictive of upgrade. Conclusion Because the majority of patients can be safely managed with radiologic surveillance, a selective approach for surgical excision is recommended. Our proposed criteria for excision include pathologic/radiologic discordance or sampling by ultrasound-guided CNB without vacuum assistance when the patient is symptomatic or lesion size is ≥ 1.5 cm.
KW - Breast
KW - Core needle biopsy
KW - Criteria
KW - Papilloma
KW - Upgrade
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U2 - 10.1016/j.clbc.2013.08.007
DO - 10.1016/j.clbc.2013.08.007
M3 - Article
C2 - 24119786
AN - SCOPUS:84889078402
SN - 1526-8209
VL - 13
SP - 439
EP - 449
JO - Clinical breast cancer
JF - Clinical breast cancer
IS - 6
ER -