Tags

Type your tag names separated by a space and hit enter

Papillary lesions initially diagnosed at ultrasound-guided vacuum-assisted breast biopsy: rate of malignancy based on subsequent surgical excision.
Ann Surg Oncol. 2011 Sep; 18(9):2506-14.AS

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 χ(2) 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.

Authors+Show Affiliations

Department of Radiology, Seoul National University Hospital, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21369740

Citation

Chang, Jung Min, et al. "Papillary Lesions Initially Diagnosed at Ultrasound-guided Vacuum-assisted Breast Biopsy: Rate of Malignancy Based On Subsequent Surgical Excision." Annals of Surgical Oncology, vol. 18, no. 9, 2011, pp. 2506-14.
Chang JM, Han W, Moon WK, et al. Papillary lesions initially diagnosed at ultrasound-guided vacuum-assisted breast biopsy: rate of malignancy based on subsequent surgical excision. Ann Surg Oncol. 2011;18(9):2506-14.
Chang, J. M., Han, W., Moon, W. K., Cho, N., Noh, D. Y., Park, I. A., & Jung, E. J. (2011). Papillary lesions initially diagnosed at ultrasound-guided vacuum-assisted breast biopsy: rate of malignancy based on subsequent surgical excision. Annals of Surgical Oncology, 18(9), 2506-14. https://doi.org/10.1245/s10434-011-1617-3
Chang JM, et al. Papillary Lesions Initially Diagnosed at Ultrasound-guided Vacuum-assisted Breast Biopsy: Rate of Malignancy Based On Subsequent Surgical Excision. Ann Surg Oncol. 2011;18(9):2506-14. PubMed PMID: 21369740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Papillary lesions initially diagnosed at ultrasound-guided vacuum-assisted breast biopsy: rate of malignancy based on subsequent surgical excision. AU - Chang,Jung Min, AU - Han,Wonsik, AU - Moon,Woo Kyung, AU - Cho,Nariya, AU - Noh,Dong-Young, AU - Park,In-Ae, AU - Jung,Eun-Jung, Y1 - 2011/03/03/ PY - 2010/11/09/received PY - 2011/3/4/entrez PY - 2011/3/4/pubmed PY - 2012/1/4/medline SP - 2506 EP - 14 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 18 IS - 9 N2 - 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 χ(2) 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. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/21369740/Papillary_lesions_initially_diagnosed_at_ultrasound_guided_vacuum_assisted_breast_biopsy:_rate_of_malignancy_based_on_subsequent_surgical_excision_ L2 - https://dx.doi.org/10.1245/s10434-011-1617-3 DB - PRIME DP - Unbound Medicine ER -