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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Gendler
Leah S
LS
Department of Surgery, Beth Israel Medical Center, New York, NY, USA.
Feldman
Sheldon M
SM
Balassanian
Ronald
R
Riker
Mary A
MA
Frencher
Stanley K
SK
Whelan
Denise B
DB
Anne
Shalini
S
Gross
Joshua D
JD
Cohen
Jean-Marc
JM
Boolbol
Susan K
SK
D001707:Biopsy, Needle / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D010212:Papilloma / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012189:Retrospective Studies