Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy? Journal Article


Authors: Liberman, L.; Tornos, C.; Huzjan, R.; Bartella, L.; Morris, E. A.; David Dershaw, D.
Article Title: Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy?
Abstract: OBJECTIVE. The study objective was to determine the cancer frequency in lesions yielding a benign, concordant diagnosis of papilloma at percutaneous breast biopsy. MATERIALS AND METHODS. Retrospective review was performed of 3,864 lesions that had percutaneous imaging-guided biopsy. In 50 lesions (1.3%), percutaneous biopsy yielded a benign, concordant diagnosis of papilloma. Surgical pathology (n = 25) or minimum 2 years' mammographic follow-up (n = 10) was available for 35 lesions that had biopsy with 11-gauge vacuum-assisted (n = 20) or 14-gauge automated (n = 15) needles. Medical records, imaging studies, and histologic results were reviewed. RESULTS. Cancer was found in five (14%) of the 35 lesions yielding a benign, concordant diagnosis of papilloma at percutaneous biopsy. Cancer histology was ductal carcinoma in situ in four (80%) and node-negative invasive cancer in one. Four (80%) of five cancers were identified due to interval change at follow-up (median, 22 months; range, 7-25 months). In six (17%) of 35 lesions, surgery revealed high-risk lesions including atypical ductal hyperplasia (n = 3), radial scar (n = 2), and lobular carcinoma in situ (n = 1). There was a significantly (p = 0.02) higher frequency of cancer or high-risk lesion in women with multiple versus solitary papillomas and a trend (p = 0.09) toward a higher cancer rate in women with versus without a family history of breast cancer. Breast cancer history, menopausal status, mammographic pattern, biopsy method, and removal of imaging target had no significant impact on cancer rate. CONCLUSION. In our study of percutaneously diagnosed papillomas, surgery revealed cancer in 14% and high-risk lesions in 17%. Lesions yielding a benign, concordant diagnosis of papilloma at percutaneous biopsy may warrant surgical excision. © American Roentgen Ray Society.
Keywords: adult; human tissue; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; histopathology; follow up; methodology; diagnostic accuracy; treatment indication; breast cancer; image analysis; breast; pathology; diagnostic imaging; breast neoplasms; medical record review; retrospective study; automation; biopsy; women's imaging; mammography; breast tumor; hyperplasia; device; papilloma; menopause; needle; percutaneous biopsy; breast biopsy; vacuum; sonography; breast papilloma; breast duct; apparatus; breast duct carcinoma in situ; breast duct hyperplasia
Journal Title: American Journal of Roentgenology
Volume: 186
Issue: 5
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2006-05-01
Start Page: 1328
End Page: 1334
Language: English
DOI: 10.2214/ajr.05.0151
PUBMED: 16632727
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 65" - "Export Date: 4 June 2012" - "CODEN: AJROA" - "Source: Scopus"
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Citation Impact
MSK Authors
  1. Carmen Tornos
    27 Tornos
  2. Renata Huzjan
    1 Huzjan
  3. D David Dershaw
    223 Dershaw
  4. Laura Liberman
    172 Liberman
  5. Elizabeth A Morris
    329 Morris