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.
Department of Surgery, Beth Israel Medical Center, New York, NY, USA.
Leah S
LS
Gendler
Sheldon M
SM
Feldman
Ronald
R
Balassanian
Mary A
MA
Riker
Stanley K
SK
Frencher
Denise B
DB
Whelan
Shalini
S
Anne
Joshua D
JD
Gross
Jean-Marc
JM
Cohen
Susan K
SK
Boolbol
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