title: Intraductal papillomas of the breast: diagnosis and management of 151 patients.
abstract: BACKGROUND
  The assessment of papillary lesions continues to be a challenging area in breast radiology and pathology. The management of intraductal papillomas without atypia of the breast remains controversial. The purpose of the present study was to determine diagnostic accuracy of radiographical diagnosis, core biopsy, and surgical excision in papillary breast lesions.
  
  
  METHODS
  By using files from 1995 to 2010, 151 cases of intraductal papilloma with or without atypia were identified. Patients were stratified as follows: core biopsy followed by surgical excision (n = 61), core biopsy alone (n = 19), and surgical excision alone (n = 71).
  
  
  RESULTS
  The upstage rate of intraductal papillomas without atypia on core biopsy to atypia or malignancy on excision was 8.9%. Excision specimens revealed intraductal papillomas without atypia in 68 out of 71 cases, and atypical papillomas in 3 cases.
  
  
  CONCLUSIONS
  Our findings suggest that radiographic and histopathological diagnosis of intraductal papillomas show high accuracy and good concordance. In cases where the radiographic diagnosis reveals suspicious lesions core biopsy represents the first choice.
authors.affiliation: Department of Gynecology, Interdisciplinary Breast Center, Charité University Medicine Berlin, Germany. Christiane.richter-ehrenstein@charite.de
authors.forename: Christiane
authors.initials: C
authors.lastname: Richter-Ehrenstein
authors.forename: Felicia
authors.initials: F
authors.lastname: Tombokan
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Fallenberg
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.forename: Carsten
authors.initials: C
authors.lastname: Denkert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D003657:Decision Making; D005260:Female; D005858:Germany; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D018300:Papilloma, Intraductal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity