title: Vacuum-assisted core biopsy in diagnosis and treatment of intraductal papillomas.
abstract: BACKGROUND
  The aim of this study was to assess the value of mammographically-guided and ultrasonographically-guided vacuum-assisted core biopsy (VACB) in the diagnosis and treatment of intraductal papillomas of breast and to answer the question of whether biopsy with the Mammotome (Mammotome; Cincinnati, OH) allows the avoidance of surgery in these patients.
  
  
  METHODS
  In the period 2000 to 2010, a total of 1896 vacuum-assisted core biopsies were performed, of which 1183 were ultrasonographically guided and 713 were mammographically guided (stereotaxic).
  
  
  RESULTS
  In 62 patients (3.2%) histopathologic examination confirmed intraductal papilloma, and in 12 patients (19.4%) atypical lesions were also found. Open surgical biopsy specimens revealed invasive cancer in 2 women these 12 women (false-negative rate, 16.7%; negative predictive value, 83.3%). Biopsy specimens from the remaining 50 patients (80.6%) revealed papilloma without atypia, and further clinical observation and imaging examinations did not show recurrence or malignant transformation of lesions. Hematoma developed in 3 (4.8%) patients as a complication of biopsy; surgical intervention was not required in any of the patients.
  
  
  CONCLUSIONS
  VACB is a minimally invasive and efficient method for diagnosing intraductal papilloma of the breast. If histopathologic examination confirms a benign lesion and corresponds to the clinical presentation, surgery may be avoided. However in all cases, histopathologic diagnosis of papilloma with atypical hyperplasia or a suspected malignant lesion in imaging examinations, despite negative biopsy results, should always be an indication for surgical excision.
authors.affiliation: Ist Chair of General Surgery and Clinic of General, Oncological and Gastroenterological Surgery, Jagiellonian University Medical College, Krakow, Poland. wkibil@op.pl
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kibil
authors.forename: Diana
authors.initials: D
authors.lastname: Hodorowicz-Zaniewska
authors.forename: Tadeusz J
authors.initials: TJ
authors.lastname: Popiela
authors.forename: Jan
authors.initials: J
authors.lastname: Kulig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000601:surgery; D009367:Neoplasm Staging; D018300:Papilloma, Intraductal / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis; D016217:Ultrasonography, Mammary; D014618:Vacuum; D055815:Young Adult