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Non-Malignant Breast Papillary Lesions - B3 Diagnosed on Ultrasound - Guided 14-Gauge Needle Core Biopsy: Analysis of 114 Cases from a Single Institution and Review of the Literature

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Pathology & Oncology Research

Abstract

One-hundred-fourteen consecutive cases of breast ultrasound-guided 14-gauge needle core biopsy (14G NCB) performed from January 2001 to June 2013 and diagnosed as non-malignant papillary lesion (PL)-B3, were reviewed and compared with definitive histological diagnosis on surgical excision (SE) to evaluate the diagnostic accuracy of ultrasound-guided 14G NCB. PL with epithelial atypia on 14G NCB were associated to malignancy on definitive histological diagnosis on SE in 22 (7 DCIS and 15 invasive carcinomas) of 46 cases with an underestimation rate of 47.8 %, while 9 (4 DCIS and 5 invasive carcinomas) cases out of 68 cases of PL without epithelial atypia were upgraded to carcinoma with an underestimation rate of 13.2 %. In cases of PL with epithelial atypia on ultrasound-guided 14G NCB, SE appears mandatory due to the high risk of associated malignancy. The diagnosis of PL without epithelial atypia on ultrasound-guided 14G NCB does not exclude malignancy at subsequent SE, consequently further assessment (by surgical or vacuum-assisted excision) is recommended to avoid the risk of delaying a diagnosis of malignancy, although this tends to be lower (1 in 8 patients).

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Acknowledgments

The authors wish to thank surgeons working in the Breast Unit of the Careggi University Hospital of Florence: Dr. Marco Bernini, Dr. Donato Casella, Dr. Silvia Nesi, Dr. Lorenzo Orzalesi, Dr. Roberta Simoncini, Dr. Luis Sanchez, and Prof. Tommaso Susini for their general support.

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The authors declare that there is no conflict of interest

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Authors and Affiliations

  1. Pathological Anatomy Unit, Department of Surgery and Translational Medicine, University of Florence – Careggi University Hospital, Largo G.A. Brambilla 3, 50134, Florence, Italy

    Simonetta Bianchi, Valeria Saladino & Vania Vezzosi

  2. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy

    Benedetta Bendinelli & Domenico Palli

  3. Senology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy

    Beniamino Brancato

  4. Diagnostic Senology Unit, Careggi University Hospital, Florence, Italy

    Jacopo Nori

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  1. Simonetta Bianchi
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  2. Benedetta Bendinelli
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  4. Vania Vezzosi
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Correspondence to Simonetta Bianchi.

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Bianchi, S., Bendinelli, B., Saladino, V. et al. Non-Malignant Breast Papillary Lesions - B3 Diagnosed on Ultrasound - Guided 14-Gauge Needle Core Biopsy: Analysis of 114 Cases from a Single Institution and Review of the Literature. Pathol. Oncol. Res. 21, 535–546 (2015). https://doi.org/10.1007/s12253-014-9882-7

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