Significance of papillary lesions at percutaneous breast biopsy

Edna K. Valdes, Paul I. Tartter, Elvita Genelus-Dominique, Deborah Alexis Guilbaud, Sharon Rosenbaum-Smith, Alison Estabrook

Research output: Contribution to journalArticlepeer-review

66 Scopus citations

Abstract

Background: The management of nonpalpable papillary lesions found in specimens obtained by percutaneous breast biopsy is controversial. We reviewed the treatment of patients found to have papillary lesions by stereotactic, sonographic, or fine-needle aspiration breast biopsy to identify indications for surgical excision. Methods: Consecutive patients with intraductal papilloma, atypical papilloma/papilloma with atypical ductal hyperplasia, papillary neoplasm, and papillomatosis according to percutaneous breast biopsy were identified from radiology records. The charts were reviewed to identify patients who had subsequent surgical excision, and the pathologic findings were correlated with the biopsy method and indications for surgery. Results: Papillary lesions were found in 120 biopsy samples from 109 patients. Malignancy was found at operation in 19 (24%) of 80 lesions that underwent surgical excision: 12 (63%) were ductal carcinoma-in-situ, 4 (21%) were infiltrating ductal carcinoma, 2 (11%) were infiltrating papillary carcinoma, and 1 (5%) was intracystic papillary carcinoma. Malignancy was found in 9 (30%) of 30 fine-needle biopsy papillary lesions, 6 (35%) of 17 core biopsy papillary lesions, and 4 (12%) of 33 stereotactic biopsy papillary lesions. Malignancy was missed significantly less frequently with stereotactic biopsy (P < .05). Conclusions: Malignancy is frequently found at surgical excision for papillary lesions found on percutaneous breast biopsy. Malignancy is missed significantly less frequently with stereotactic biopsy.

Original languageEnglish
Pages (from-to)480-482
Number of pages3
JournalAnnals of Surgical Oncology
Volume13
Issue number4
DOIs
StatePublished - Apr 2006
Externally publishedYes

Keywords

  • Intraductal papilloma
  • Papillary carcinoma
  • Papillary lesion
  • Papillary neoplasm
  • Papillomatosis
  • Percutaneous breast biopsy

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