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Ultrasonography-guided core needle biopsy in differential diagnosis of papillary breast tumors.
Acta Radiol. 2009 Sep; 50(7):722-9.AR

Abstract

BACKGROUND

Papillary lesions of the breast are considered diagnostically challenging for various reasons. A relatively high malignancy rate in final pathological analysis has in many cases necessitated excision of these lesions, regardless of core needle biopsy (CNB).

PURPOSE

To assess mammographic, sonographic, and CNB findings of papillary lesions, and to correlate them with final histology obtained by surgical excision.

MATERIAL AND METHODS

From 2000-2006, 29 benign and 19 malignant papillary tumors examined with CNB were surgically removed. Mammographic, sonographic, and CNB results were analyzed and correlated with final histology.

RESULTS

On ultrasonography (US), 69% (20/29) of the benign lesions were solid and 31% (9/29) were cystic, and 47% of the malignant lesions (9/19) were solid and 53% (10/19) were cystic. The mammographic findings were nonspecific, although most of the malignant tumors (67%, 12/18) were categorized as BI-RADS 4 lesions. The sensitivity, specificity, and positive predictive value of the core needle biopsy histology was 32% (6/19), 100% (29/29), and 100% (6/6), respectively, for papillary carcinoma. A negative predictive value of 91% (21/23) for malignancy and 48% (11/23) for either atypia or malignancy was shown. Of the lesions with CNB diagnosis of benign papillary lesion with atypia, 58% (11/19) turned out to be malignant and 11% (2/19) were benign on surgery.

CONCLUSION

The probability of malignancy is low when the CNB result shows a benign papillary lesion with no atypia. However, the only way to reliably diagnose atypical papillary lesions is to surgically remove all papillary tumors, irrespective of the CNB result. Differentiation between benign and malignant lesions or malignant noninvasive and invasive tumors is not possible based on sonographic or mammographic appearance.

Authors+Show Affiliations

Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland. michaela.bode@fimnet.fiNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19488890

Citation

Bode, M K., et al. "Ultrasonography-guided Core Needle Biopsy in Differential Diagnosis of Papillary Breast Tumors." Acta Radiologica (Stockholm, Sweden : 1987), vol. 50, no. 7, 2009, pp. 722-9.
Bode MK, Rissanen T, Apaja-Sarkkinen M. Ultrasonography-guided core needle biopsy in differential diagnosis of papillary breast tumors. Acta Radiol. 2009;50(7):722-9.
Bode, M. K., Rissanen, T., & Apaja-Sarkkinen, M. (2009). Ultrasonography-guided core needle biopsy in differential diagnosis of papillary breast tumors. Acta Radiologica (Stockholm, Sweden : 1987), 50(7), 722-9. https://doi.org/10.1080/02841850902977963
Bode MK, Rissanen T, Apaja-Sarkkinen M. Ultrasonography-guided Core Needle Biopsy in Differential Diagnosis of Papillary Breast Tumors. Acta Radiol. 2009;50(7):722-9. PubMed PMID: 19488890.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrasonography-guided core needle biopsy in differential diagnosis of papillary breast tumors. AU - Bode,M K, AU - Rissanen,T, AU - Apaja-Sarkkinen,M, PY - 2009/6/3/entrez PY - 2009/6/3/pubmed PY - 2009/9/30/medline SP - 722 EP - 9 JF - Acta radiologica (Stockholm, Sweden : 1987) JO - Acta Radiol VL - 50 IS - 7 N2 - BACKGROUND: Papillary lesions of the breast are considered diagnostically challenging for various reasons. A relatively high malignancy rate in final pathological analysis has in many cases necessitated excision of these lesions, regardless of core needle biopsy (CNB). PURPOSE: To assess mammographic, sonographic, and CNB findings of papillary lesions, and to correlate them with final histology obtained by surgical excision. MATERIAL AND METHODS: From 2000-2006, 29 benign and 19 malignant papillary tumors examined with CNB were surgically removed. Mammographic, sonographic, and CNB results were analyzed and correlated with final histology. RESULTS: On ultrasonography (US), 69% (20/29) of the benign lesions were solid and 31% (9/29) were cystic, and 47% of the malignant lesions (9/19) were solid and 53% (10/19) were cystic. The mammographic findings were nonspecific, although most of the malignant tumors (67%, 12/18) were categorized as BI-RADS 4 lesions. The sensitivity, specificity, and positive predictive value of the core needle biopsy histology was 32% (6/19), 100% (29/29), and 100% (6/6), respectively, for papillary carcinoma. A negative predictive value of 91% (21/23) for malignancy and 48% (11/23) for either atypia or malignancy was shown. Of the lesions with CNB diagnosis of benign papillary lesion with atypia, 58% (11/19) turned out to be malignant and 11% (2/19) were benign on surgery. CONCLUSION: The probability of malignancy is low when the CNB result shows a benign papillary lesion with no atypia. However, the only way to reliably diagnose atypical papillary lesions is to surgically remove all papillary tumors, irrespective of the CNB result. Differentiation between benign and malignant lesions or malignant noninvasive and invasive tumors is not possible based on sonographic or mammographic appearance. SN - 1600-0455 UR - https://www.unboundmedicine.com/medline/citation/19488890/Ultrasonography_guided_core_needle_biopsy_in_differential_diagnosis_of_papillary_breast_tumors_ L2 - https://journals.sagepub.com/doi/10.1080/02841850902977963?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -