Breast intraductal papillomas without atypia in radiologic-pathologic concordant core-needle biopsies: Rate of upgrade to carcinoma at excision Journal Article


Authors: Pareja, F.; Corben, A. D.; Brennan, S. B.; Murray, M. P.; Bowser, Z. L.; Jakate, K.; Sebastiano, C.; Morrow, M.; Morris, E. A.; Brogi, E.
Article Title: Breast intraductal papillomas without atypia in radiologic-pathologic concordant core-needle biopsies: Rate of upgrade to carcinoma at excision
Abstract: BACKGROUND: The surgical management of mammary intraductal papilloma without atypia (IDP) identified at core-needle biopsy (CNB) is controversial. This study assessed the rate of upgrade to carcinoma at surgical excision (EXC). METHODS: This study identified women with a CNB diagnosis of intraductal papilloma without atypia or carcinoma at a cancer center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. The radiologic and clinicopathologic features of patients with a CNB diagnosis of IDP were correlated with an upgrade to carcinoma at EXC. RESULTS: The study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent EXC. The upgrade rate was 2.3% (4 of 171). The upgraded lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥ 8 mm away. Twenty-four women (25 IDPs) did not undergo EXC and had stable imaging on follow-up (median, 23.5 months). CONCLUSIONS: The upgrade rate at EXC for IDPs diagnosed at CNB with radiologic-pathologic concordance was 2.3%. These findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2819–2827. © 2016 American Cancer Society. © 2016 American Cancer Society
Keywords: excision; breast; biopsy; carcinoma; papilloma; core needle; atypia; upgrade
Journal Title: Cancer
Volume: 122
Issue: 18
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2016-09-15
Start Page: 2819
End Page: 2827
Language: English
DOI: 10.1002/cncr.30118
PUBMED: 27315013
PROVIDER: scopus
PMCID: PMC5014573
DOI/URL:
Notes: Article -- Export Date: 3 October 2016 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Monica Morrow
    773 Morrow
  2. Adriana Dionigi Corben
    66 Corben
  3. Melissa P Murray
    123 Murray
  4. Elizabeth A Morris
    341 Morris
  5. Sandra B Brennan
    40 Brennan
  6. Edi Brogi
    519 Brogi
  7. Zenica Leslie Bowser
    23 Bowser