Iskender Sinan Genco1, Bugra Tugertimur2, Panagiotis A Manolas2, Adnan Hasanovic3, Sabina Hajiyeva3. 1. Northwell Health Lenox Hill Hospital, Department of Pathology and Laboratory Medicine, 100 E 77th street, New York, NY, 10075, USA. Electronic address: iskendergenco@gmail.com. 2. Northwell Health Lenox Hill Hospital, Department of Surgery, 100 E 77th street, New York, NY, 10075, USA. 3. Northwell Health Lenox Hill Hospital, Department of Pathology and Laboratory Medicine, 100 E 77th street, New York, NY, 10075, USA.
Abstract
BACKGROUND: The aim of the study was to determine the upgrade rate on excision of intraductal papilloma (IDP) without atypia diagnosed on breast core needle biopsy (CNB). METHODS: We searched our pathology department database for breast CNB with a diagnosis of IDP from 2013 to 2018. The exclusion criteria included radiologic-pathologic discordance, atypia on the same CNB, absence of histologic slides to review or absence of excision information. Upgrade was defined as ductal carcinoma in situ (DCIS) or invasive cancer identified on excision. RESULTS: 126 IDP without atypia cases from 94 patients were identified. The upgrade rate was 1.58% (2/126). Both upgrade cases showed DCIS with low and intermediate nuclear grade. Histologic size of IDP ≥1 cm was the only statistically significant predictor factor for an upgrade on excision. CONCLUSION: The results suggest that non-surgical management of patients with radiologic-pathologic concordant IDP without atypia diagnosed on CNB may be appropriate in routine practice.
BACKGROUND: The aim of the study was to determine the upgrade rate on excision of intraductal papilloma (IDP) without atypia diagnosed on breast core needle biopsy (CNB). METHODS: We searched our pathology department database for breast CNB with a diagnosis of IDP from 2013 to 2018. The exclusion criteria included radiologic-pathologic discordance, atypia on the same CNB, absence of histologic slides to review or absence of excision information. Upgrade was defined as ductal carcinoma in situ (DCIS) or invasive cancer identified on excision. RESULTS: 126 IDP without atypia cases from 94 patients were identified. The upgrade rate was 1.58% (2/126). Both upgrade cases showed DCIS with low and intermediate nuclear grade. Histologic size of IDP ≥1 cm was the only statistically significant predictor factor for an upgrade on excision. CONCLUSION: The results suggest that non-surgical management of patients with radiologic-pathologic concordant IDP without atypia diagnosed on CNB may be appropriate in routine practice.
Authors: Faina Nakhlis; Gabrielle M Baker; Melissa Pilewskie; Rebecca Gelman; Katherina Z Calvillo; Kandice Ludwig; Priscilla F McAuliffe; Shawna Willey; Laura H Rosenberger; Catherine Parker; Kristalyn Gallagher; Lisa Jacobs; Sheldon Feldman; Paulina Lange; Stephen D DeSantis; Stuart J Schnitt; Tari A King Journal: Ann Surg Oncol Date: 2020-10-12 Impact factor: 5.344