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Intraductal papillomas on core biopsy can be upgraded to malignancy on subsequent excisional biopsy regardless of the presence of atypical features.
Pathol Int. 2015 Jun; 65(6):293-300.PI

Abstract

Intraductal papillary lesions of the breast constitute a heterogeneous entity, including benign intraductal papilloma (IDP) with or without atypia and malignant papillary carcinoma. Differentiating between these diagnoses can be challenging. We re-evaluated core biopsy specimens that were diagnosed as IDP and the corresponding surgical excision specimens, and assessed the potential risk for the diagnosis to be modified to malignancy based on excision. By sorting the pathology database of the National Cancer Center Hospital, Tokyo, we identified 146 core biopsy cases that were histologically diagnosed as IDP between 1997 and 2013. The re-evaluated diagnosis was IDP without atypia in 79 (54%) patients, IDP with atypia in 66 (45%), and ductal carcinoma in situ (DCIS) in 1 (1%). Among the 34 patients (23%) who underwent surgical excision subsequent to core biopsy, histological diagnosis was upgraded to carcinoma, excluding lobular carcinoma in situ (LCIS), in 14 (41%) cases, including 4 (33%) of 12 IDPs without atypia and 10 (45%) of 22 IDPs with atypia. Complete surgical excision should be kept in mind for all IDPs diagnosed on core biopsy, not only IDPs with atypia but IDPs without atypia, especially when clinical or imaging diagnosis findings cannot rule out the possibility of malignancy, because papillary lesions comprise a variety of morphological appearances.

Authors+Show Affiliations

Breast Surgery Division, National Cancer Center Hospital, Tokyo, Japan.Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan. Department of Basic Pathology, National Defense Medical College, Tokorozawa, Japan.Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.Breast Surgery Division, National Cancer Center Hospital, Tokyo, Japan.Breast Surgery Division, National Cancer Center Hospital, Tokyo, Japan.Breast Surgery Division, National Cancer Center Hospital, Tokyo, Japan.Breast Surgery Division, National Cancer Center Hospital, Tokyo, Japan.

Pub Type(s)

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

Language

eng

PubMed ID

25801805

Citation

Shiino, Sho, et al. "Intraductal Papillomas On Core Biopsy Can Be Upgraded to Malignancy On Subsequent Excisional Biopsy Regardless of the Presence of Atypical Features." Pathology International, vol. 65, no. 6, 2015, pp. 293-300.
Shiino S, Tsuda H, Yoshida M, et al. Intraductal papillomas on core biopsy can be upgraded to malignancy on subsequent excisional biopsy regardless of the presence of atypical features. Pathol Int. 2015;65(6):293-300.
Shiino, S., Tsuda, H., Yoshida, M., Jimbo, K., Asaga, S., Hojo, T., & Kinoshita, T. (2015). Intraductal papillomas on core biopsy can be upgraded to malignancy on subsequent excisional biopsy regardless of the presence of atypical features. Pathology International, 65(6), 293-300. https://doi.org/10.1111/pin.12285
Shiino S, et al. Intraductal Papillomas On Core Biopsy Can Be Upgraded to Malignancy On Subsequent Excisional Biopsy Regardless of the Presence of Atypical Features. Pathol Int. 2015;65(6):293-300. PubMed PMID: 25801805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraductal papillomas on core biopsy can be upgraded to malignancy on subsequent excisional biopsy regardless of the presence of atypical features. AU - Shiino,Sho, AU - Tsuda,Hitoshi, AU - Yoshida,Masayuki, AU - Jimbo,Kenjiro, AU - Asaga,Sota, AU - Hojo,Takashi, AU - Kinoshita,Takayuki, Y1 - 2015/03/20/ PY - 2014/03/26/received PY - 2015/02/09/accepted PY - 2015/3/25/entrez PY - 2015/3/25/pubmed PY - 2017/4/18/medline KW - World Health Organization (WHO) classification KW - breast cancer KW - core needle biopsy KW - intraductal papilloma KW - surgical excision KW - upgrade SP - 293 EP - 300 JF - Pathology international JO - Pathol Int VL - 65 IS - 6 N2 - Intraductal papillary lesions of the breast constitute a heterogeneous entity, including benign intraductal papilloma (IDP) with or without atypia and malignant papillary carcinoma. Differentiating between these diagnoses can be challenging. We re-evaluated core biopsy specimens that were diagnosed as IDP and the corresponding surgical excision specimens, and assessed the potential risk for the diagnosis to be modified to malignancy based on excision. By sorting the pathology database of the National Cancer Center Hospital, Tokyo, we identified 146 core biopsy cases that were histologically diagnosed as IDP between 1997 and 2013. The re-evaluated diagnosis was IDP without atypia in 79 (54%) patients, IDP with atypia in 66 (45%), and ductal carcinoma in situ (DCIS) in 1 (1%). Among the 34 patients (23%) who underwent surgical excision subsequent to core biopsy, histological diagnosis was upgraded to carcinoma, excluding lobular carcinoma in situ (LCIS), in 14 (41%) cases, including 4 (33%) of 12 IDPs without atypia and 10 (45%) of 22 IDPs with atypia. Complete surgical excision should be kept in mind for all IDPs diagnosed on core biopsy, not only IDPs with atypia but IDPs without atypia, especially when clinical or imaging diagnosis findings cannot rule out the possibility of malignancy, because papillary lesions comprise a variety of morphological appearances. SN - 1440-1827 UR - https://www.unboundmedicine.com/medline/citation/25801805/Intraductal_papillomas_on_core_biopsy_can_be_upgraded_to_malignancy_on_subsequent_excisional_biopsy_regardless_of_the_presence_of_atypical_features_ L2 - https://doi.org/10.1111/pin.12285 DB - PRIME DP - Unbound Medicine ER -