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Papillary breast lesions diagnosed by core biopsy require complete excision.
Eur J Surg Oncol. 2012 Nov; 38(11):1029-35.EJ

Abstract

BACKGROUND

Surgical excision of papillary breast lesions with atypia diagnosed using core needle biopsy (CNB) has been accepted; however, the management of benign papillary lesions (without atypia) has been controversial. The purpose of this study was to evaluate the surgical outcome of nonmalignant papillary lesions diagnosed by ultrasound-guided 14-gauge CNB, and to establish clear guidelines on management of these lesions.

METHODS

We retrospectively identified 268 nonmalignant papillary breast lesions, including 203 benign lesions and 65 atypical lesions, diagnosed by CNB and subsequently surgically excised in 250 women at our institution between July 2004 and October 2010. For each lesion, medical records and radiologic and pathologic reports were reviewed and coded. We compared the histological upgrade among the collected variables.

RESULTS

On histological examination after surgical excision, 15.4% atypical papillary lesions and 5.9% benign lesions were upgraded to malignant, and 20.2% benign lesions were upgraded to atypical. Atypia (P = 0.015) was significantly associated with malignant upgrade at excision. No clinical or radiologic variable was helpful in predicting the possibility of histological upgrade of CNB-diagnosed nonmalignant papillary lesions.

CONCLUSIONS

Nonmalignant papillary lesions diagnosed with CNB showed an unacceptable pathological upgrade rate after excision. Therefore, surgical excision should be performed for all papillary lesions of the breast for definitive diagnosis.

Authors+Show Affiliations

Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Neihu 114, Taipei, Taiwan, ROC.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22959140

Citation

Fu, C-Y, et al. "Papillary Breast Lesions Diagnosed By Core Biopsy Require Complete Excision." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 38, no. 11, 2012, pp. 1029-35.
Fu CY, Chen TW, Hong ZJ, et al. Papillary breast lesions diagnosed by core biopsy require complete excision. Eur J Surg Oncol. 2012;38(11):1029-35.
Fu, C. Y., Chen, T. W., Hong, Z. J., Chan, D. C., Young, C. Y., Chen, C. J., Hsieh, C. B., Hsu, H. H., Peng, Y. J., Lu, H. E., & Yu, J. C. (2012). Papillary breast lesions diagnosed by core biopsy require complete excision. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 38(11), 1029-35. https://doi.org/10.1016/j.ejso.2012.08.019
Fu CY, et al. Papillary Breast Lesions Diagnosed By Core Biopsy Require Complete Excision. Eur J Surg Oncol. 2012;38(11):1029-35. PubMed PMID: 22959140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Papillary breast lesions diagnosed by core biopsy require complete excision. AU - Fu,C-Y, AU - Chen,T-W, AU - Hong,Z-J, AU - Chan,D-C, AU - Young,C-Y, AU - Chen,C-J, AU - Hsieh,C-B, AU - Hsu,H-H, AU - Peng,Y-J, AU - Lu,H-E, AU - Yu,J-C, Y1 - 2012/09/07/ PY - 2012/03/26/received PY - 2012/08/16/revised PY - 2012/08/20/accepted PY - 2012/9/11/entrez PY - 2012/9/11/pubmed PY - 2013/2/12/medline SP - 1029 EP - 35 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 38 IS - 11 N2 - BACKGROUND: Surgical excision of papillary breast lesions with atypia diagnosed using core needle biopsy (CNB) has been accepted; however, the management of benign papillary lesions (without atypia) has been controversial. The purpose of this study was to evaluate the surgical outcome of nonmalignant papillary lesions diagnosed by ultrasound-guided 14-gauge CNB, and to establish clear guidelines on management of these lesions. METHODS: We retrospectively identified 268 nonmalignant papillary breast lesions, including 203 benign lesions and 65 atypical lesions, diagnosed by CNB and subsequently surgically excised in 250 women at our institution between July 2004 and October 2010. For each lesion, medical records and radiologic and pathologic reports were reviewed and coded. We compared the histological upgrade among the collected variables. RESULTS: On histological examination after surgical excision, 15.4% atypical papillary lesions and 5.9% benign lesions were upgraded to malignant, and 20.2% benign lesions were upgraded to atypical. Atypia (P = 0.015) was significantly associated with malignant upgrade at excision. No clinical or radiologic variable was helpful in predicting the possibility of histological upgrade of CNB-diagnosed nonmalignant papillary lesions. CONCLUSIONS: Nonmalignant papillary lesions diagnosed with CNB showed an unacceptable pathological upgrade rate after excision. Therefore, surgical excision should be performed for all papillary lesions of the breast for definitive diagnosis. SN - 1532-2157 UR - https://www.unboundmedicine.com/medline/citation/22959140/Papillary_breast_lesions_diagnosed_by_core_biopsy_require_complete_excision_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(12)01218-8 DB - PRIME DP - Unbound Medicine ER -