Management of breast papillary lesions diagnosed in ultrasound-guided vacuum-assisted and core needle biopsies
Corresponding Author
Rin Yamaguchi
Department of Pathology and Laboratory Medicine, Kurume General Hospital, Kurume, Japan
Department of Pathology, Kurume General Hospital, Kurume, Japan
Address for correspondence: R Yamaguchi, MD, Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. e-mail: [email protected]Search for more papers by this authorMaki Tanaka
Department of Surgery, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorGary M Tse
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
Search for more papers by this authorMiki Yamaguchi
Department of Surgery, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorHiroshi Terasaki
Department of Radiology, Kurume General Hospital, Kurume, Okayama, Japan
Search for more papers by this authorYoshitake Hirai
Department of Laboratory Medicine, Kurume General Hospital, Kurume, Okayama, Japan
Search for more papers by this authorYasuhide Nonaka
Department of Laboratory Medicine, Kurume General Hospital, Kurume, Okayama, Japan
Search for more papers by this authorMichi Morita
Department of Pathology and Laboratory Medicine, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorToshiro Yokoyama
Department of Pathology and Laboratory Medicine, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorNaoki Kanomata
Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japan
Search for more papers by this authorYoshiki Naito
Department of Pathology, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorJun Akiba
Department of Pathology, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorHirohisa Yano
Department of Pathology, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorCorresponding Author
Rin Yamaguchi
Department of Pathology and Laboratory Medicine, Kurume General Hospital, Kurume, Japan
Department of Pathology, Kurume General Hospital, Kurume, Japan
Address for correspondence: R Yamaguchi, MD, Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. e-mail: [email protected]Search for more papers by this authorMaki Tanaka
Department of Surgery, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorGary M Tse
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
Search for more papers by this authorMiki Yamaguchi
Department of Surgery, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorHiroshi Terasaki
Department of Radiology, Kurume General Hospital, Kurume, Okayama, Japan
Search for more papers by this authorYoshitake Hirai
Department of Laboratory Medicine, Kurume General Hospital, Kurume, Okayama, Japan
Search for more papers by this authorYasuhide Nonaka
Department of Laboratory Medicine, Kurume General Hospital, Kurume, Okayama, Japan
Search for more papers by this authorMichi Morita
Department of Pathology and Laboratory Medicine, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorToshiro Yokoyama
Department of Pathology and Laboratory Medicine, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorNaoki Kanomata
Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japan
Search for more papers by this authorYoshiki Naito
Department of Pathology, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorJun Akiba
Department of Pathology, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorHirohisa Yano
Department of Pathology, Kurume General Hospital, Kurume, Japan
Search for more papers by this authorAbstract
Aims
To assess the outcome of breast papillary lesions diagnosed by ultrasound-guided core needle biopsy (CB) or vacuum-assisted ‘mammotome’ biopsy (MT), the accuracy of these diagnoses, and whether it is justified not to undertake surgical excision of non-malignant papillary lesions so diagnosed.
Methods and results
Among 3219 (MT, 2195; CB, 1024) breast biopsies spanning 5 years, 185 (5.7%) papillary lesions [MT, 162 (88%); CB, 23 (12%)] were identified. Of these, 142 cases (77%; MT/CB, 125/17) were benign, 24 (13%, 23/1) were atypical, and 19 (10%; 14/5) were malignant. Of the 142 benign cases, 114 had imaging follow-up (FU) (FU period 2–81 months); 17 of 114 cases were excised, and four were malignant (3.5%) (FU period 4–57 months). Of the 24 atypical cases (23 had FU), 19 were excised: six were benign (32%) and 13 malignant (68%). The remaining four cases were considered to be non-malignant (FU period 7–54 months).
Conclusions
Benign papillary lesions diagnosed by MT or CB might not require immediate excision, but should receive imaging FU for at least 5 years. Excision should be performed in cases showing changes in imaging features, as the possibilities of carcinoma coexisting with papilloma or carcinoma developing from papilloma cannot be excluded, as illustrated by the 4% upgrade rate at excision in this study.
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