Annals of Surgical Oncology

, Volume 13, Issue 4, pp 480–482 | Cite as

Significance of Papillary Lesions at Percutaneous Breast Biopsy

  • Edna K. Valdes
  • Paul I. Tartter
  • Elvita Genelus-Dominique
  • Deborah-Alexis Guilbaud
  • Sharon Rosenbaum-Smith
  • Alison Estabrook
Article

Abstract

Background

The management of nonpalpable papillary lesions found in specimens obtained by percutaneous breast biopsy is controversial. We reviewed the treatment of patients found to have papillary lesions by stereotactic, sonographic, or fine-needle aspiration breast biopsy to identify indications for surgical excision.

Methods

Consecutive patients with intraductal papilloma, atypical papilloma/papilloma with atypical ductal hyperplasia, papillary neoplasm, and papillomatosis according to percutaneous breast biopsy were identified from radiology records. The charts were reviewed to identify patients who had subsequent surgical excision, and the pathologic findings were correlated with the biopsy method and indications for surgery.

Results

Papillary lesions were found in 120 biopsy samples from 109 patients. Malignancy was found at operation in 19 (24%) of 80 lesions that underwent surgical excision: 12 (63%) were ductal carcinoma-in-situ, 4 (21%) were infiltrating ductal carcinoma, 2 (11%) were infiltrating papillary carcinoma, and 1 (5%) was intracystic papillary carcinoma. Malignancy was found in 9 (30%) of 30 fine-needle biopsy papillary lesions, 6 (35%) of 17 core biopsy papillary lesions, and 4 (12%) of 33 stereotactic biopsy papillary lesions. Malignancy was missed significantly less frequently with stereotactic biopsy (P < .05).

Conclusions

Malignancy is frequently found at surgical excision for papillary lesions found on percutaneous breast biopsy. Malignancy is missed significantly less frequently with stereotactic biopsy.

Keywords

Papillary lesion Papillary neoplasm Intraductal papilloma Papillomatosis Papillary carcinoma Percutaneous breast biopsy 

References

  1. 1.
    Rosen EL, Bentley RC, Baker JA, Soo MS. Imaging-guided core needle biopsy of papillary lesions of the breast. AJR Am J Roentgenol 2002;179:1185–92PubMedGoogle Scholar
  2. 2.
    Agoff SN, Lawton TJ. Papillary lesions of the breast with and without atypical ductal hyperplasia. Am J Clin Pathol 2004;122:440–3PubMedGoogle Scholar
  3. 3.
    Gendler LH, Feldman SM, Balassanian R, et al. Association of breast cancer with papillary lesions identified at percutaneous image-guided breast biopsy. Am J Surg 2004;188:365–70CrossRefPubMedGoogle Scholar
  4. 4.
    Gardner PJ, Garvican J, Haigh I, Liston JC. Needle core biopsy can reliably distinguish between benign and malignant papillary lesions of the breast. Histopathology 2005;46:320–7Google Scholar
  5. 5.
    Mercado CL, Hamela-Bena D, Singer C, et al. Papillary lesions of the breast: evaluation with stereotactic directional vacuum-assisted biopsy. Radiology 2001;221:650–5.PubMedGoogle Scholar
  6. 6.
    Renshaw AA, Derhagopian RP, Tizol-Blanco DM, Gould EW. Papillomas and atypical papillomas in breast core needle biopsy specimens. Am J Clin Pathol 2002;122:217–21Google Scholar
  7. 7.
    Tan PH, Aw MY, Yip G, et al. Cytokeratins in papillary lesions of the breast: is there a role in distinguishing intraductal papilloma from papillary ductal carcinoma in situ? Am J Surg Pathol 2005;29:625–32PubMedGoogle Scholar
  8. 8.
    Masood S, Loya A, Khalbuss W. Is core needle biopsy superior to fine-needle aspiration biopsy in the diagnosis of papillary breast lesions? Diagn Cytopathol 2003;28:329–34CrossRefPubMedGoogle Scholar
  9. 9.
    Hoda SA, Rosen PP. Observations on the pathologic diagnosis of selected unusual lesions in needle core biopsies of the breast. Breast J 2004;10:522–7PubMedGoogle Scholar

Copyright information

© The Society of Surgical Oncology, Inc. 2006

Authors and Affiliations

  • Edna K. Valdes
    • 1
  • Paul I. Tartter
    • 1
  • Elvita Genelus-Dominique
    • 1
  • Deborah-Alexis Guilbaud
    • 2
  • Sharon Rosenbaum-Smith
    • 1
  • Alison Estabrook
    • 1
  1. 1.Department of SurgeryComprehensive Breast Service, St. Luke’s Roosevelt Medical CenterNew York
  2. 2.Department of RadiologyComprehensive Breast Service, St. Luke’s Roosevelt Medical CenterNew York

Personalised recommendations