Tags

Type your tag names separated by a space and hit enter

Asymptomatic Benign Papilloma Without Atypia Diagnosed at Ultrasonography-Guided 14-Gauge Core Needle Biopsy: Which Subgroup can be Managed by Observation?
Ann Surg Oncol. 2016 06; 23(6):1860-6.AS

Abstract

BACKGROUND

For asymptomatic benign papillomas detected at ultrasonography-guided 14-gauge core-needle biopsy (US-CNB), the decision to perform excision versus observation has been a topic of debate. We sought to determine which subgroup of asymptomatic benign papillomas without atypia diagnosed at US-CNB can be safely managed by observation versus immediate excision.

MATERIALS

Overall, 230 asymptomatic benign papillomas in 197 women (mean age 46.6 ± 9.5 years; range 22-78), diagnosed at US-CNB using immunohistochemistry staining when needed and then managed by surgery (n = 144) or vacuum-assisted excision (VAE) with at least 12 months of follow-up after benign VAE results (n = 86) were included in this study. The upgrade rate to malignancy was calculated. Clinical and radiological variables, including age, size, Breast Image Reporting and Data System (BI-RADS) category, and imaging-pathology correlation were evaluated to find associations with malignancy using multivariate analysis.

RESULTS

The upgrade rate to malignancy was 2.6 % (6 of 230): four were ductal carcinomas in situ and two were 1.5- and 9-mm-sized invasive ductal carcinomas without lymph node metastasis. The upgrade rates of papillomas with a BI-RADS category 3-4a and imaging-pathology concordance were 1.4 and 1.8 %, respectively. Category 4b-5 and imaging-pathology discordance were independently associated with malignancy, with upgrade rates of 13 and 50 %, respectively. Age and lesion size were not associated with malignancy.

CONCLUSION

Asymptomatic benign papillomas with probable benign or low suspicious US features or imaging-pathology concordance can be followed-up as opposed to immediate excision.

Authors+Show Affiliations

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.Biostatistics Collaboration Unit, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea. artemis4u@yuhs.ac.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26920388

Citation

Kim, Soo-Yeon, et al. "Asymptomatic Benign Papilloma Without Atypia Diagnosed at Ultrasonography-Guided 14-Gauge Core Needle Biopsy: Which Subgroup Can Be Managed By Observation?" Annals of Surgical Oncology, vol. 23, no. 6, 2016, pp. 1860-6.
Kim SY, Kim EK, Lee HS, et al. Asymptomatic Benign Papilloma Without Atypia Diagnosed at Ultrasonography-Guided 14-Gauge Core Needle Biopsy: Which Subgroup can be Managed by Observation? Ann Surg Oncol. 2016;23(6):1860-6.
Kim, S. Y., Kim, E. K., Lee, H. S., Kim, M. J., Yoon, J. H., Koo, J. S., & Moon, H. J. (2016). Asymptomatic Benign Papilloma Without Atypia Diagnosed at Ultrasonography-Guided 14-Gauge Core Needle Biopsy: Which Subgroup can be Managed by Observation? Annals of Surgical Oncology, 23(6), 1860-6. https://doi.org/10.1245/s10434-016-5144-0
Kim SY, et al. Asymptomatic Benign Papilloma Without Atypia Diagnosed at Ultrasonography-Guided 14-Gauge Core Needle Biopsy: Which Subgroup Can Be Managed By Observation. Ann Surg Oncol. 2016;23(6):1860-6. PubMed PMID: 26920388.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Asymptomatic Benign Papilloma Without Atypia Diagnosed at Ultrasonography-Guided 14-Gauge Core Needle Biopsy: Which Subgroup can be Managed by Observation? AU - Kim,Soo-Yeon, AU - Kim,Eun-Kyung, AU - Lee,Hye Sun, AU - Kim,Min Jung, AU - Yoon,Jung Hyun, AU - Koo,Ja Seung, AU - Moon,Hee Jung, Y1 - 2016/02/26/ PY - 2015/10/31/received PY - 2016/2/28/entrez PY - 2016/2/28/pubmed PY - 2018/2/17/medline SP - 1860 EP - 6 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 23 IS - 6 N2 - BACKGROUND: For asymptomatic benign papillomas detected at ultrasonography-guided 14-gauge core-needle biopsy (US-CNB), the decision to perform excision versus observation has been a topic of debate. We sought to determine which subgroup of asymptomatic benign papillomas without atypia diagnosed at US-CNB can be safely managed by observation versus immediate excision. MATERIALS: Overall, 230 asymptomatic benign papillomas in 197 women (mean age 46.6 ± 9.5 years; range 22-78), diagnosed at US-CNB using immunohistochemistry staining when needed and then managed by surgery (n = 144) or vacuum-assisted excision (VAE) with at least 12 months of follow-up after benign VAE results (n = 86) were included in this study. The upgrade rate to malignancy was calculated. Clinical and radiological variables, including age, size, Breast Image Reporting and Data System (BI-RADS) category, and imaging-pathology correlation were evaluated to find associations with malignancy using multivariate analysis. RESULTS: The upgrade rate to malignancy was 2.6 % (6 of 230): four were ductal carcinomas in situ and two were 1.5- and 9-mm-sized invasive ductal carcinomas without lymph node metastasis. The upgrade rates of papillomas with a BI-RADS category 3-4a and imaging-pathology concordance were 1.4 and 1.8 %, respectively. Category 4b-5 and imaging-pathology discordance were independently associated with malignancy, with upgrade rates of 13 and 50 %, respectively. Age and lesion size were not associated with malignancy. CONCLUSION: Asymptomatic benign papillomas with probable benign or low suspicious US features or imaging-pathology concordance can be followed-up as opposed to immediate excision. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/26920388/Asymptomatic_Benign_Papilloma_Without_Atypia_Diagnosed_at_Ultrasonography_Guided_14_Gauge_Core_Needle_Biopsy:_Which_Subgroup_can_be_Managed_by_Observation L2 - https://dx.doi.org/10.1245/s10434-016-5144-0 DB - PRIME DP - Unbound Medicine ER -