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Management of Clinically and Mammographically Occult Benign Papillary Lesions Diagnosed at Ultrasound-Guided 14-Gauge Breast Core Needle Biopsy.
J Ultrasound Med. 2016 Nov; 35(11):2325-2332.JU

Abstract

OBJECTIVES

To determine how to manage clinically and mammographically occult benign papillary lesions diagnosed at ultrasound (US)-guided 14-gauge breast core needle biopsy (CNB) by evaluating their upgrade rates.

METHODS

From our pathologic database of US-guided 14-gauge breast CNB, 69 benign papillomas and 9 atypical papillomas with available subsequent excisional findings (surgery or vacuum-assisted removal with additional US follow-up for ≥2 years) or US follow-up alone (≥2 years) were included in this study. We analyzed their upgrade rates by using excisional or US follow-up findings, with no change at 2 years as the reference standard. Patient age, lesion size, lesion distance from the nipple, multiplicity, imaging-histologic concordance, and histologic findings were compared between groups with and without upgrades by statistical analysis.

RESULTS

Surgical excision was performed in 53 (67.9%) of 78 benign papillary lesions and revealed 5 upgrades (11.4%) to atypical papillomas in 44 benign papillomas and 2 upgrades (22.2%) to ductal carcinomas in situ in 9 atypical papillomas. Among 12 benign papillomas (15.4%) with vacuum-assisted removal and US follow-up (≥2 years), 1 (8.3%) was upgraded to atypical papilloma. The remaining 13 benign papillomas (16.7%) were followed with US and were stable after a 2-year follow-up period. There were no significant differences in the variables between the groups.

CONCLUSIONS

Uniform surgical excision is not a reasonable management strategy for clinically and mammographically occult benign papillary lesions diagnosed at US-guided 14-gauge breast CNB. Clinically and mammographically occult benign papillary lesions may be subsequently managed by vacuum-assisted removal or imaging follow-up if atypia is not found.

Authors+Show Affiliations

Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea.Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea hhkkjung@hanmail.net.Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea.Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea.Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27629753

Citation

Moon, Sung Mo, et al. "Management of Clinically and Mammographically Occult Benign Papillary Lesions Diagnosed at Ultrasound-Guided 14-Gauge Breast Core Needle Biopsy." Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, vol. 35, no. 11, 2016, pp. 2325-2332.
Moon SM, Jung HK, Ko KH, et al. Management of Clinically and Mammographically Occult Benign Papillary Lesions Diagnosed at Ultrasound-Guided 14-Gauge Breast Core Needle Biopsy. J Ultrasound Med. 2016;35(11):2325-2332.
Moon, S. M., Jung, H. K., Ko, K. H., Kim, Y., & Lee, K. S. (2016). Management of Clinically and Mammographically Occult Benign Papillary Lesions Diagnosed at Ultrasound-Guided 14-Gauge Breast Core Needle Biopsy. Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, 35(11), 2325-2332.
Moon SM, et al. Management of Clinically and Mammographically Occult Benign Papillary Lesions Diagnosed at Ultrasound-Guided 14-Gauge Breast Core Needle Biopsy. J Ultrasound Med. 2016;35(11):2325-2332. PubMed PMID: 27629753.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of Clinically and Mammographically Occult Benign Papillary Lesions Diagnosed at Ultrasound-Guided 14-Gauge Breast Core Needle Biopsy. AU - Moon,Sung Mo, AU - Jung,Hae Kyoung, AU - Ko,Kyung Hee, AU - Kim,Youdong, AU - Lee,Kyong Sik, Y1 - 2016/09/14/ PY - 2015/11/19/received PY - 2016/02/15/accepted PY - 2016/10/30/pubmed PY - 2017/6/10/medline PY - 2016/9/16/entrez KW - breast KW - breast ultrasound KW - core needle biopsy KW - papillary lesion KW - surgical excision KW - ultrasound SP - 2325 EP - 2332 JF - Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine JO - J Ultrasound Med VL - 35 IS - 11 N2 - OBJECTIVES: To determine how to manage clinically and mammographically occult benign papillary lesions diagnosed at ultrasound (US)-guided 14-gauge breast core needle biopsy (CNB) by evaluating their upgrade rates. METHODS: From our pathologic database of US-guided 14-gauge breast CNB, 69 benign papillomas and 9 atypical papillomas with available subsequent excisional findings (surgery or vacuum-assisted removal with additional US follow-up for ≥2 years) or US follow-up alone (≥2 years) were included in this study. We analyzed their upgrade rates by using excisional or US follow-up findings, with no change at 2 years as the reference standard. Patient age, lesion size, lesion distance from the nipple, multiplicity, imaging-histologic concordance, and histologic findings were compared between groups with and without upgrades by statistical analysis. RESULTS: Surgical excision was performed in 53 (67.9%) of 78 benign papillary lesions and revealed 5 upgrades (11.4%) to atypical papillomas in 44 benign papillomas and 2 upgrades (22.2%) to ductal carcinomas in situ in 9 atypical papillomas. Among 12 benign papillomas (15.4%) with vacuum-assisted removal and US follow-up (≥2 years), 1 (8.3%) was upgraded to atypical papilloma. The remaining 13 benign papillomas (16.7%) were followed with US and were stable after a 2-year follow-up period. There were no significant differences in the variables between the groups. CONCLUSIONS: Uniform surgical excision is not a reasonable management strategy for clinically and mammographically occult benign papillary lesions diagnosed at US-guided 14-gauge breast CNB. Clinically and mammographically occult benign papillary lesions may be subsequently managed by vacuum-assisted removal or imaging follow-up if atypia is not found. SN - 1550-9613 UR - https://www.unboundmedicine.com/medline/citation/27629753/Management_of_Clinically_and_Mammographically_Occult_Benign_Papillary_Lesions_Diagnosed_at_Ultrasound_Guided_14_Gauge_Breast_Core_Needle_Biopsy_ L2 - https://doi.org/10.7863/ultra.15.11049 DB - PRIME DP - Unbound Medicine ER -