Benign breast papillary lesions diagnosed on core biopsy: upgrade rate and risk factors associated with malignancy on surgical excision

Virchows Archiv : an International Journal of Pathology
Christine MacCollPhillip Williams

Abstract

Evaluation of radiologically detected breast lesions is a common task in surgical pathology. Some benign lesions on biopsy are associated with an upgrade to in situ or invasive carcinoma on excision. The non-atypical breast papilloma has published upgrade rates of 0 to 29%. Traditionally, papillomas have been managed surgically, but the wide range of upgrade rates has raised uncertainty about the need for routine surgical excision. This study aims to identify risk factors associated with upgrade and determine the upgrade rate of non-atypical papillomas at our institution. In a retrospective review of pathology reports, we identified 266 patients with a diagnosis of benign papilloma on breast core biopsy. One hundred eighty-two patients underwent surgical resection. The final surgical pathology reports of all patients were reviewed and divided into one of two groups-benign or malignant. Twenty-one patients had a final diagnosis of in situ or invasive carcinoma, resulting in an upgrade rate of 12%. Radiologically detected lesions with calcifications were at higher risk for upgrade (OR = 4.45, 95% CI 1.08-18.27) than lesions without calcifications. Additionally, advanced patient age (OR = 1.07, 95% CI 1.03-1.13) and lesion size gr...Continue Reading

References

Jul 22, 2008·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·H S TsengD R Chen
Jan 22, 2014·Human Pathology·Paul S WeismanMegan E Sullivan
Oct 30, 2016·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Sung Mo MoonKyong Sik Lee
Apr 26, 2017·Clinical Breast Cancer·Dayoung KoEun-Kyu Kim
Feb 8, 2018·Surgical Pathology Clinics·Jonathan D Marotti, Stuart J Schnitt

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Citations

Aug 7, 2020·Insights Into Imaging·Javier Del RiegoAmaya Martín
Oct 28, 2020·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Edi Brogi, Melissa Krystel-Whittemore
Sep 14, 2020·Annals of Diagnostic Pathology·Alexandre A Vdovenko
Apr 21, 2021·Annals of Surgical Oncology·Jessica LimbergJennifer L Marti
Nov 5, 2021·Virchows Archiv : an International Journal of Pathology·Janina KulkaSigurd F Lax

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