Association of breast cancer with papillary lesions identified at percutaneous image-guided breast biopsy

• Published in: The American journal of surgery Vol. 188; no. 4; pp. 365 - 370
• Main Authors: Gendler, Leah S., Feldman, Sheldon M., Balassanian, Ronald, Riker, Mary A., Frencher, Stanley K., Whelan, Denise B., Anne, Shalini, Gross, Joshua D., Cohen, Jean-Marc, Boolbol, Susan K.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2004; Elsevier; Elsevier Limited
• Subjects: Atypical ductal hyperplasia; Biological and medical sciences; Biopsy; Biopsy, Needle - methods; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Core-needle biopsy; Female; Fine-needle aspiration; General aspects; Gynecology. Andrology. Obstetrics; Humans; Image-guided biopsy; Mammary gland diseases; Mammography; Medical sciences; Papillary lesion; Papilloma; Papilloma - diagnostic imaging; Papilloma - pathology; Pathology; Radiography; Retrospective Studies; Smooth muscle; Tumors; Fine-needle aspiration; Image-guided biopsy; Core-needle biopsy; Papilloma; Breast cancer; Atypical ductal hyperplasia; Papillary lesion; Hyperplasia; Identification; Image; Percutaneous route; Association; Surgery; Benign neoplasm; Mammary gland; Malignant tumor; Aspiration punction; Guidance; Medicine; Mammary gland diseases; Treatment; Biopsy; Needle; Breast; Atypical; Lesion
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2004.06.026

The management of papillary lesions identified on image-guided breast biopsy remains controversial. In the literature, data regarding papillary lesions are limited because of small sample sizes. The purpose of this study was to identify the prevalence of atypical ductal hyperplasia and malignancy associated with papillary lesions identified on image-guided breast biopsy. This study is a retrospective review of 9,310 consecutive image-guided biopsies performed at our institution between January 1996 and November 2003. Patients were included if they underwent an excisional biopsy after a papillary lesion was diagnosed on image-guided biopsy. Papillary lesions were identified in 153 (2%) of the 9,310 image-guided biopsies performed, and 87 of these patients underwent subsequent excisional biopsy at our institution. Breast cancer (in situ or invasive) was identified in 15 patients (17%), and 16 patients (18%) had atypical ductal hyperplasia identified at excisional biopsy. These data suggest that excisional biopsy should be considered when a papillary lesion is identified at percutaneous image-guided breast biopsy. The final surgical pathology may impact the treatment plan, risk reduction, and/or surveillance for more than a third of patients diagnosed with a papillary lesion on image-guided biopsy.