Sung Mo Moon1, Hae Kyoung Jung2, Kyung Hee Ko1, Youdong Kim1, Kyong Sik Lee3. 1. Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea. 2. Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea hhkkjung@hanmail.net. 3. Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea.
Abstract
OBJECTIVES: To determine how to manage clinically and mammographically occult benign papillary lesions diagnosed at ultrasound (US)-guided 14-gauge breast core needle biopsy (CNB) by evaluating their upgrade rates. METHODS: From our pathologic database of US-guided 14-gauge breast CNB, 69 benign papillomas and 9 atypical papillomas with available subsequent excisional findings (surgery or vacuum-assisted removal with additional US follow-up for ≥2 years) or US follow-up alone (≥2 years) were included in this study. We analyzed their upgrade rates by using excisional or US follow-up findings, with no change at 2 years as the reference standard. Patient age, lesion size, lesion distance from the nipple, multiplicity, imaging-histologic concordance, and histologic findings were compared between groups with and without upgrades by statistical analysis. RESULTS: Surgical excision was performed in 53 (67.9%) of 78 benign papillary lesions and revealed 5 upgrades (11.4%) to atypical papillomas in 44 benign papillomas and 2 upgrades (22.2%) to ductal carcinomas in situ in 9 atypical papillomas. Among 12 benign papillomas (15.4%) with vacuum-assisted removal and US follow-up (≥2 years), 1 (8.3%) was upgraded to atypical papilloma. The remaining 13 benign papillomas (16.7%) were followed with US and were stable after a 2-year follow-up period. There were no significant differences in the variables between the groups. CONCLUSIONS: Uniform surgical excision is not a reasonable management strategy for clinically and mammographically occult benign papillary lesions diagnosed at US-guided 14-gauge breast CNB. Clinically and mammographically occult benign papillary lesions may be subsequently managed by vacuum-assisted removal or imaging follow-up if atypia is not found.
OBJECTIVES: To determine how to manage clinically and mammographically occult benign papillary lesions diagnosed at ultrasound (US)-guided 14-gauge breast core needle biopsy (CNB) by evaluating their upgrade rates. METHODS: From our pathologic database of US-guided 14-gauge breast CNB, 69 benign papillomas and 9 atypical papillomas with available subsequent excisional findings (surgery or vacuum-assisted removal with additional US follow-up for ≥2 years) or US follow-up alone (≥2 years) were included in this study. We analyzed their upgrade rates by using excisional or US follow-up findings, with no change at 2 years as the reference standard. Patient age, lesion size, lesion distance from the nipple, multiplicity, imaging-histologic concordance, and histologic findings were compared between groups with and without upgrades by statistical analysis. RESULTS: Surgical excision was performed in 53 (67.9%) of 78 benign papillary lesions and revealed 5 upgrades (11.4%) to atypical papillomas in 44 benign papillomas and 2 upgrades (22.2%) to ductal carcinomas in situ in 9 atypical papillomas. Among 12 benign papillomas (15.4%) with vacuum-assisted removal and US follow-up (≥2 years), 1 (8.3%) was upgraded to atypical papilloma. The remaining 13 benign papillomas (16.7%) were followed with US and were stable after a 2-year follow-up period. There were no significant differences in the variables between the groups. CONCLUSIONS: Uniform surgical excision is not a reasonable management strategy for clinically and mammographically occult benign papillary lesions diagnosed at US-guided 14-gauge breast CNB. Clinically and mammographically occult benign papillary lesions may be subsequently managed by vacuum-assisted removal or imaging follow-up if atypia is not found.
Authors: Christoph J Rageth; Elizabeth A M O'Flynn; Katja Pinker; Rahel A Kubik-Huch; Alexander Mundinger; Thomas Decker; Christoph Tausch; Florian Dammann; Pascal A Baltzer; Eva Maria Fallenberg; Maria P Foschini; Sophie Dellas; Michael Knauer; Caroline Malhaire; Martin Sonnenschein; Andreas Boos; Elisabeth Morris; Zsuzsanna Varga Journal: Breast Cancer Res Treat Date: 2018-11-30 Impact factor: 4.872
Authors: Abdulkhaleq A Binnuhaid; Sultan Abdulwadoud Alshoabi; Fahad H Alhazmi; Tareef S Daqqaq; Suliman G Salih; Sami A Al-Dubai Journal: J Family Med Prim Care Date: 2019-12-10