- 作者：Anupma Nayak ; Selin Carkaci ; Michael Z. Gilcrease ; Ping Liu ; Lavinia P. Middleton ; Rol ; L. Bassett Jr. ; Jinxia Zhang ; Hong Zhang ; Robin L. Coyne ; Therese B. Bevers ; Nour Sneige ; Lei Huo
- 关键词：Breast ; Core needle biopsy ; Criteria ; Papilloma ; Upgrade
- 刊名：Clinical Breast Cancer
- 出版年：December, 2013
- 年：2013
- 卷：13
- 期：6
- 页码：439-449
- 全文大小：1807 K
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聽鈮?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聽鈮?1.5 cm.