Sonographically-guided 14-gauge core needle biopsy for papillary lesions of the breast.
OBJECTIVE
We wanted to assess the need for surgical excising papillary lesions of the breast that were diagnosed upon sonographically guided 14-gauge core needle biopsy.


METHODS
Sixty-nine women (age range: 25-74 years, mean age: 51.7 years) with 69 papillary lesions (4.9%) were diagnosed and followed after performing sonographically guided 14-gauge core needle biopsies. Surgical excision was performed for 44 (64%) of 69 papillary lesions, and 25 lesions were followed with imaging studies (range: 6-46 months, mean: 17.9 months). The histologic findings upon core biopsy were compared with the surgical, imaging and follow-up findings.


RESULTS
Core needle biopsies of 69 lesions yielded tissue that was classified as benign for 43 lesions, atypical for 18 lesions and malignant for eight lesions. Of the 43 lesions that yielded benign papilloma upon core needle biopsy, one had intraductal papillary carcinoma found upon surgery. An immediate surgical biopsy was recommended for this lesion because of the imaging-histologic discordance. No additional carcinoma was found during the imaging follow-up. Surgical excision was performed for 17 atypical papillary lesions, and this revealed intraductal (n = 6) or invasive (n = 2) papillary carcinoma in 8 (47%) lesions. Of the seven intraductal papillary carcinomas, surgery revealed invasive papillary carcinoma in one (14%).


CONCLUSIONS
Our results suggest that papillary lesions of the breast that are diagnosed as benign upon sonographically guided 14-gauge core needle biopsy can be followed when the results are concordant with the imaging findings.
Ko
Eun Sook
ES
Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
Cho
Nariya
N
Cha
Joo Hee
JH
Park
Jeong Seon
JS
Kim
Sun Mi
SM
Moon
Woo Kyung
WK
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D018300:Papilloma, Intraductal / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional