Management of Intraductal Papillomas of the Breast: An Analysis of 129 Cases and Their Outcome
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The management of intraductal papillomas of the breast has been controversial; some advocate surgical excision of all lesions despite benign pathologic features, whereas others excise only those specimens with atypia.
We conducted a retrospective review of 129 core-biopsy-proven papillomas of the breast with atypia (n = 43) and without atypia (n = 86) and determined the rate of missed carcinoma in surgically excised specimen in each group.
Carcinoma was found in 22.5% of the surgically excised specimens in the atypia group (9/40) and in 3% of the surgically excised specimens in the no atypia group (1/29).
Our findings confirm the practice that papillomas with atypical features should be excised, and suggest that in patients with adequate follow-up, benign papillomas may be managed conservatively.
- Agoff, SN, Lawton, TJ (2004) Papillary lesions of the breast with and without atypical ductal hyperplasia. Can we accurately predict benign behavior from core needle biopsy?. Am J Clin Pathol 122: pp. 440-443 CrossRef
- Sydnor, MK, Wilson, JD, Hijaz, TA, Massey, HD, Shaw de Paredes, ES (2007) Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy. Radiology 242: pp. 58-62 CrossRef
- Renshaw, AA, Derhagopian, RP, Tizol-Blanco, DM, Gould, EW (2004) Papillomas and atypical papillomas in breast core needle biopsy specimens. Risk of carcinoma in subsequent excision. Am J Clin Pathol 122: pp. 217-221 CrossRef
- Sohn, V, Keylock, J, Arthurs, Z, Wilson, A, Herbert, G, Perry, J (2007) Breast papillomas in the era of percutaneous needle biopsy. Ann Surg Oncol 14: pp. 2979-2984 CrossRef
- Collins, LC, Schnitt, SJ (2008) Papillary lesions of the breast: selected diagnostic and management issues. Histopathology 52: pp. 20-29
- Jacobs, TW, Connolly, JL, Schnitt, SJ (2002) Nonmalignant lesions in breast core needle biopsies: to excise or not to excise?. Am J Surg Pathol 26: pp. 1095-1110 CrossRef
- Rizzo, M, Lund, MJ, Oprea, G, Schniederjan, M, Wood, WC, Mosunjac, M (2008) Surgical follow-up and clinical presentation of 142 breast papillary lesions diagnosed by ultrasound-guided core-needle biopsy. Ann Surg Oncol 15: pp. 1040-1047 CrossRef
- Page, DL, Salhany, KE, Jensen, RA, Dupont, WD (1996) Subsequent breast carcinoma risk after biopsy with atypia in a breast papilloma. Cancer 78: pp. 258-266 CrossRef
- Lewis, JT, Hartmann, LC, Vierkant, RA (2006) An analysis of breast cancer risk in women with single, multiple, and atypical papilloma. Am J Surg Pathol 30: pp. 665-672 CrossRef
- Tavassoli, FA (1999) Pathology of the breast. Appleton and Lange, Stamford, CT
- Marshall, LM, Hunter, DJ, Connolly, JL, Schnitt, SJ, Byrne, C, London, SJ (1997) Risk of breast cancer associated with atypical hyperplasia of lobular and ductal types. Cancer Epidemiol Biomarkers Prev 6: pp. 297-301
- Sakr, R, Rouzier, R, Salem, C, Antoine, M, Chopier, J, Arai, E (2008) Risk of breast cancer associated with papilloma. Eur J Surg Oncol 34: pp. 1304-1308
- Management of Intraductal Papillomas of the Breast: An Analysis of 129 Cases and Their Outcome
Annals of Surgical Oncology
Volume 16, Issue 8 , pp 2264-2269
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- 1. Department of Surgery, Brigham and Women’s Hospital and the Dana Farber Cancer Institute, Boston, MA, USA
- 2. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
- 3. Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA