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Annals of Surgical Oncology

, Volume 18, Issue 9, pp 2506–2514 | Cite as

Papillary Lesions Initially Diagnosed at Ultrasound-guided Vacuum-assisted Breast Biopsy: Rate of Malignancy Based on Subsequent Surgical Excision

  • Jung Min Chang
  • Wonsik Han
  • Woo Kyung MoonEmail author
  • Nariya Cho
  • Dong-Young Noh
  • In-Ae Park
  • Eun-Jung Jung
Breast Oncology

Abstract

Purpose

To prospectively determine the rate of malignancy after surgery in papillary lesions initially diagnosed at ultrasound (US)-guided 11-gauge vacuum-assisted breast biopsies.

Methods

Between May 2007 and December 2009, a total of 85 papillary lesions, including 73 benign papillomas and 12 atypical papillomas were diagnosed in 83 patients by US-guided 11-gauge vacuum-assisted breast biopsy. Surgical excision was recommended for all patients and 60 nonmalignant papillary lesions (49 benign papillomas and 11 atypical papillomas) in 60 patients (age range, 24–66 years; mean age, 45.0 years) were surgically excised. On a per-lesion basis, the upgrade rate to malignancy was calculated. Associations between clinical, lesion, and biopsy variables and the results of surgical excision were examined with a χ2 test.

Results

Surgical excision revealed the presence of benign papillomas in 34 cases, no residual lesion in 15 cases, atypical papillomas in nine cases, and ductal carcinoma-in-situ in two cases. The upgrade rate was 0% (0 of 49; 95% confidence interval 0–7.2) for benign papillomas and 18.2% (2 of 11; 95% confidence interval 2.3–51.8) for atypical papillomas. The core findings of atypical papillomas (P = 0.031) and age (P = 0.046) were associated with malignancy at excision, whereas personal or family history, presence of symptoms, multiplicity, lesion type, size, distance from the nipple, Breast Imaging Reporting and Data System (BI-RADS) category, and lesion removal at US showed no correlation to upgrade.

Conclusions

Surgical excision may not be required for lesions with a diagnosis of benign papilloma after US-guided 11-gauge vacuum-assisted breast biopsy, and a diagnosis of atypical papilloma should prompt excision for a definitive diagnosis.

Keywords

Papilloma Core Needle Biopsy Atypical Ductal Hyperplasia Nipple Discharge Papillary Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Jung Min Chang
    • 1
    • 2
  • Wonsik Han
    • 3
  • Woo Kyung Moon
    • 1
    • 2
    Email author
  • Nariya Cho
    • 1
    • 2
  • Dong-Young Noh
    • 3
  • In-Ae Park
    • 4
  • Eun-Jung Jung
    • 4
  1. 1.Department of RadiologySeoul National University HospitalSeoulKorea
  2. 2.Institute of Radiation MedicineSeoul National University Medical Research CenterSeoulKorea
  3. 3.Department of SurgerySeoul National University HospitalSeoulKorea
  4. 4.Department of PathologySeoul National University HospitalSeoulKorea

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