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Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy.
Clin Imaging. 2015 Jul-Aug; 39(4):576-81.CI

Abstract

PURPOSE

To determine the upgrade rate of benign papillomas diagnosed at image-guided vacuum-assisted core needle biopsy (VACNB) and to compare our results with the summarized literature.

MATERIALS AND METHODS

A database search was performed to identify patients older than 18 years of age with benign papillomas diagnosed at VACNB between 2004 and 2013. A total of 199 papillomas in 184 patients were identified. Clinical, imaging, and pathological features for each were analyzed. Patients who were subsequently diagnosed with malignancy at the site of papilloma, either at surgical excision or upon imaging follow-up, were compared with those not upgraded. Upgrade was defined as a diagnosis of invasive carcinoma or ductal carcinoma in situ (DCIS).

RESULTS

Of 199 papillomas, 110 (55.3%) were diagnosed at ultrasound-guided VACNB, 78 (39.2%) were diagnosed at stereotactic-guided VACNB, and 11 (5.5%) were diagnosed at magnetic resonance imaging-guided VACNB. Surgical excision was performed for 89 (44.7%), and the remaining 110 (55.3%) underwent imaging follow-up. Two patients were subsequently diagnosed with invasive carcinoma and 4 were found with DCIS. The upgrade rate across both groups was 3% (6 of 199). Masses with calcifications (P=.001) and smaller needle gauge at VACNB (P=.02) had a significant association with upgrade.

CONCLUSION

Benign papillomas diagnosed with VACNB demonstrated a 3% upgrade rate to malignancy, which is similar to the 2.9% upgrade rate calculated by compiling applicable published literature. Conservative management with imaging follow-up as opposed to surgical excision may be appropriate in cases where an initial diagnosis of benign papilloma is made with VACNB. Benign papillomas associated with calcifications on imaging should be considered for surgical excision given their increased association with malignancy.

Authors+Show Affiliations

The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Jeffrey.Hawley@osumc.edu.The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Hannah.Lawther@osumc.edu.The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Barbaros.Erdal@osumc.edu.The Ohio State University College of Medicine Department of Biomedical Informatics, 2012 Kenny Road, Columbus, OH 43221. Electronic address: vedat.yildiz@osumc.edu.The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Selin.Carkaci@osumc.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25691147

Citation

Hawley, Jeffrey R., et al. "Outcomes of Benign Breast Papillomas Diagnosed at Image-guided Vacuum-assisted Core Needle Biopsy." Clinical Imaging, vol. 39, no. 4, 2015, pp. 576-81.
Hawley JR, Lawther H, Erdal BS, et al. Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy. Clin Imaging. 2015;39(4):576-81.
Hawley, J. R., Lawther, H., Erdal, B. S., Yildiz, V. O., & Carkaci, S. (2015). Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy. Clinical Imaging, 39(4), 576-81. https://doi.org/10.1016/j.clinimag.2015.01.017
Hawley JR, et al. Outcomes of Benign Breast Papillomas Diagnosed at Image-guided Vacuum-assisted Core Needle Biopsy. Clin Imaging. 2015 Jul-Aug;39(4):576-81. PubMed PMID: 25691147.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy. AU - Hawley,Jeffrey R, AU - Lawther,Hannah, AU - Erdal,Barbaros Selnur, AU - Yildiz,Vedat O, AU - Carkaci,Selin, Y1 - 2015/02/07/ PY - 2014/12/16/received PY - 2015/01/29/accepted PY - 2015/2/19/entrez PY - 2015/2/19/pubmed PY - 2016/1/19/medline KW - Benign papilloma KW - Breast cancer KW - Upgrade rate KW - Vacuum-assisted biopsy SP - 576 EP - 81 JF - Clinical imaging JO - Clin Imaging VL - 39 IS - 4 N2 - PURPOSE: To determine the upgrade rate of benign papillomas diagnosed at image-guided vacuum-assisted core needle biopsy (VACNB) and to compare our results with the summarized literature. MATERIALS AND METHODS: A database search was performed to identify patients older than 18 years of age with benign papillomas diagnosed at VACNB between 2004 and 2013. A total of 199 papillomas in 184 patients were identified. Clinical, imaging, and pathological features for each were analyzed. Patients who were subsequently diagnosed with malignancy at the site of papilloma, either at surgical excision or upon imaging follow-up, were compared with those not upgraded. Upgrade was defined as a diagnosis of invasive carcinoma or ductal carcinoma in situ (DCIS). RESULTS: Of 199 papillomas, 110 (55.3%) were diagnosed at ultrasound-guided VACNB, 78 (39.2%) were diagnosed at stereotactic-guided VACNB, and 11 (5.5%) were diagnosed at magnetic resonance imaging-guided VACNB. Surgical excision was performed for 89 (44.7%), and the remaining 110 (55.3%) underwent imaging follow-up. Two patients were subsequently diagnosed with invasive carcinoma and 4 were found with DCIS. The upgrade rate across both groups was 3% (6 of 199). Masses with calcifications (P=.001) and smaller needle gauge at VACNB (P=.02) had a significant association with upgrade. CONCLUSION: Benign papillomas diagnosed with VACNB demonstrated a 3% upgrade rate to malignancy, which is similar to the 2.9% upgrade rate calculated by compiling applicable published literature. Conservative management with imaging follow-up as opposed to surgical excision may be appropriate in cases where an initial diagnosis of benign papilloma is made with VACNB. Benign papillomas associated with calcifications on imaging should be considered for surgical excision given their increased association with malignancy. SN - 1873-4499 UR - https://www.unboundmedicine.com/medline/citation/25691147/Outcomes_of_benign_breast_papillomas_diagnosed_at_image_guided_vacuum_assisted_core_needle_biopsy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-7071(15)00042-X DB - PRIME DP - Unbound Medicine ER -