TY - JOUR
T1 - Microcalcification is an important factor in the management of breast intraductal papillomas diagnosed on core biopsy
AU - Li, Xin
AU - Weaver, Olena
AU - Desouki, Mohamed Mokhtar
AU - Dabbs, David
AU - Shyum, Susan
AU - Carter, Gloria
AU - Zhao, Chengquan
PY - 2012/12
Y1 - 2012/12
N2 - The follow-up excision (FUE) results were analyzed from 370 cases diagnosed as intraductal papilloma on breast core needle biopsy (CNB) with no history of malignancy or other risk factors. Of these cases, 98.6% were rendered a Breast Imaging Reporting and Data System score of 4 on mammography before the CNB. Fifty-one cases (13.8%) were found to have microcalcifications on microscopic examination of CNB. A total of 7 (1.9%) of 370 cases were upgraded to invasive carcinoma, ductal carcinoma in situ, or pleomorphic lobular carcinoma in situ on FUE. Six of 51 (11.8%) cases with microcalcifications found on imaging and CNB were upgraded to ductal carcinoma in situ or invasive carcinoma, whereas only 1 (0.3%) of 319 cases without microcalcifications was upgraded to pleomorphic lobular carcinoma in situ (P = .003). Results of a multivariate analysis adjusted for age confirmed that microcalcifications was a risk factor for upgrading to cancer, independent of age. Our results indicate that surgical excision is required for intraductal papilloma diagnosed on CNB if microcalcifications are present. However, excision may not be required for those who have no microcalcifications on CNB and no other known risk factors.
AB - The follow-up excision (FUE) results were analyzed from 370 cases diagnosed as intraductal papilloma on breast core needle biopsy (CNB) with no history of malignancy or other risk factors. Of these cases, 98.6% were rendered a Breast Imaging Reporting and Data System score of 4 on mammography before the CNB. Fifty-one cases (13.8%) were found to have microcalcifications on microscopic examination of CNB. A total of 7 (1.9%) of 370 cases were upgraded to invasive carcinoma, ductal carcinoma in situ, or pleomorphic lobular carcinoma in situ on FUE. Six of 51 (11.8%) cases with microcalcifications found on imaging and CNB were upgraded to ductal carcinoma in situ or invasive carcinoma, whereas only 1 (0.3%) of 319 cases without microcalcifications was upgraded to pleomorphic lobular carcinoma in situ (P = .003). Results of a multivariate analysis adjusted for age confirmed that microcalcifications was a risk factor for upgrading to cancer, independent of age. Our results indicate that surgical excision is required for intraductal papilloma diagnosed on CNB if microcalcifications are present. However, excision may not be required for those who have no microcalcifications on CNB and no other known risk factors.
KW - Breast core biopsy
KW - Intraductal papilloma
KW - Microcalcifications
KW - Upgrading
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U2 - 10.1309/AJCPTDQCHIWH4OHM
DO - 10.1309/AJCPTDQCHIWH4OHM
M3 - Article
C2 - 23161711
AN - SCOPUS:84869227980
SN - 0002-9173
VL - 138
SP - 789
EP - 795
JO - American journal of clinical pathology
JF - American journal of clinical pathology
IS - 6
ER -