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Benign papilloma diagnosed on image-guided 14 G core biopsy of the breast: effect of lesion type on likelihood of malignancy at excision.
Clin Radiol. 2013 Apr; 68(4):383-7.CR

Abstract

AIM

To ascertain the negative predictive value (NPV) for atypia and malignancy of 14 G core biopsy of papillomas and to determine whether lesion type influences the likelihood of malignancy at lesion excision.

MATERIALS AND METHODS

Ninety-six lesions with a 14 G core biopsy diagnosis of benign papilloma without atypia in 95 women were included. The imaging features (mass or microcalcification), biopsy mode, and number of core samples taken were documented. All patients subsequently underwent lesion excision with either extensive vacuum-assisted biopsy (VAB; 72 lesions) or surgery (24 lesions). Mammographic follow-up of at least 2 years was available for 32 lesions that were benign at VAB.

RESULTS

Atypia or malignancy was found more commonly in association with microcalcification (six of 29 lesions: 21%; median number of nine 14 G cores) than a mass (five of 67 lesions: 7%; median number of three 14 G cores), although the difference does not reach statistical significance (p = 0.088). The NPV of a 14 G core biopsy diagnosis of papilloma for atypia or malignancy is 89% (85/96). Disease underestimation may be more common in microcalcification lesions despite the greater number of cores obtained.

CONCLUSION

Excision (using VAB or surgically) of all papillomas diagnosed as benign on 14 G needle core biopsy is recommended. Surgery may be more appropriate than VAB for some microcalcification lesions unless they are small and can be confidently removed in their entirety using VAB.

Authors+Show Affiliations

Breast Unit, Royal Bolton Hospital, Bolton, UK. anthony.maxwell@nhs.netNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23206431

Citation

Maxwell, A J., et al. "Benign Papilloma Diagnosed On Image-guided 14 G Core Biopsy of the Breast: Effect of Lesion Type On Likelihood of Malignancy at Excision." Clinical Radiology, vol. 68, no. 4, 2013, pp. 383-7.
Maxwell AJ, Mataka G, Pearson JM. Benign papilloma diagnosed on image-guided 14 G core biopsy of the breast: effect of lesion type on likelihood of malignancy at excision. Clin Radiol. 2013;68(4):383-7.
Maxwell, A. J., Mataka, G., & Pearson, J. M. (2013). Benign papilloma diagnosed on image-guided 14 G core biopsy of the breast: effect of lesion type on likelihood of malignancy at excision. Clinical Radiology, 68(4), 383-7. https://doi.org/10.1016/j.crad.2012.06.136
Maxwell AJ, Mataka G, Pearson JM. Benign Papilloma Diagnosed On Image-guided 14 G Core Biopsy of the Breast: Effect of Lesion Type On Likelihood of Malignancy at Excision. Clin Radiol. 2013;68(4):383-7. PubMed PMID: 23206431.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Benign papilloma diagnosed on image-guided 14 G core biopsy of the breast: effect of lesion type on likelihood of malignancy at excision. AU - Maxwell,A J, AU - Mataka,G, AU - Pearson,J M, Y1 - 2012/12/01/ PY - 2012/03/21/received PY - 2012/05/27/revised PY - 2012/06/01/accepted PY - 2012/12/5/entrez PY - 2012/12/5/pubmed PY - 2013/4/30/medline SP - 383 EP - 7 JF - Clinical radiology JO - Clin Radiol VL - 68 IS - 4 N2 - AIM: To ascertain the negative predictive value (NPV) for atypia and malignancy of 14 G core biopsy of papillomas and to determine whether lesion type influences the likelihood of malignancy at lesion excision. MATERIALS AND METHODS: Ninety-six lesions with a 14 G core biopsy diagnosis of benign papilloma without atypia in 95 women were included. The imaging features (mass or microcalcification), biopsy mode, and number of core samples taken were documented. All patients subsequently underwent lesion excision with either extensive vacuum-assisted biopsy (VAB; 72 lesions) or surgery (24 lesions). Mammographic follow-up of at least 2 years was available for 32 lesions that were benign at VAB. RESULTS: Atypia or malignancy was found more commonly in association with microcalcification (six of 29 lesions: 21%; median number of nine 14 G cores) than a mass (five of 67 lesions: 7%; median number of three 14 G cores), although the difference does not reach statistical significance (p = 0.088). The NPV of a 14 G core biopsy diagnosis of papilloma for atypia or malignancy is 89% (85/96). Disease underestimation may be more common in microcalcification lesions despite the greater number of cores obtained. CONCLUSION: Excision (using VAB or surgically) of all papillomas diagnosed as benign on 14 G needle core biopsy is recommended. Surgery may be more appropriate than VAB for some microcalcification lesions unless they are small and can be confidently removed in their entirety using VAB. SN - 1365-229X UR - https://www.unboundmedicine.com/medline/citation/23206431/Benign_papilloma_diagnosed_on_image_guided_14_G_core_biopsy_of_the_breast:_effect_of_lesion_type_on_likelihood_of_malignancy_at_excision_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0009-9260(12)00517-X DB - PRIME DP - Unbound Medicine ER -