title: US-guided vacuum-assisted percutaneous excision for management of benign papilloma without atypia diagnosed at US-guided 14-gauge core needle biopsy.
abstract: OBJECTIVE
  To assess the diagnostic accuracy of ultrasound (US)-guided vacuum-assisted excision (VAE) for the postbiopsy management of benign papilloma without atypia after US-guided 14-gauge core needle biopsy (CNB).
  
  
  METHODS
  This was an institutional review board-approved retrospective study, with a waiver of informed consent. After a review of the histologic results and postbiopsy management of US-guided CNB performed from January 2007 through April 2009, 122 benign papillomas without atypia were diagnosed at CNB and excised percutaneously with US-guided VAE. Among them, a total of 67 papillomas having surgical excision (n = 5) or at least 2 years' US follow-up (n = 62) after VAE were enrolled onto this study. We reviewed the medical records, US findings, and pathologic results obtained before and after VAE. Over the follow-up period, whether any malignancy at the site of the VAE was diagnosed was evaluated.
  
  
  RESULTS
  The pathologic results of 67 VAEs were benign in 63 (94%) and atypical in four (6%). None of 63 benign lesions proved to be malignant after surgical excision (n = 1) or US follow-up (n = 62). Of four atypical lesions, however, one was upgraded to ductal carcinoma-in-situ (25%) after surgical excision. Of 62 benign VAE results having US follow-up, 56 (90.3%) showed no residual lesion at the site of the VAE.
  
  
  CONCLUSIONS
  For the postbiopsy management of benign papilloma without atypia after US-guided CNB, US-guided VAE was accurate and could be alternative to surgery. In cases of diagnosis of atypical lesion at VAE, however, surgery should be performed for a definitive diagnosis.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Youk
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Kim
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Son
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Kwak
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010212:Papilloma / Q000000981:diagnostic imaging* / Q000601:surgery*; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary; D014618:Vacuum; D055815:Young Adult