Benign Intraductal Papilloma without Atypia on Core Needle Biopsy Has a Low Rate of Upgrading to Malignancy after Excision
한송희, 김미림, Chung Yul-Ri, 윤보라, 장미정, 김선미, 강은영, 김은규, 박소연,
소속 상세정보
한송희 ( Han Song-Hee )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Pathology
김미림 ( Kim Mi-Lim )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Pathology
( Chung Yul-Ri )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Pathology
윤보라 ( Yun Bo-La )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Radiology
장미정 ( Jang Mi-Jung )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Radiology
김선미 ( Kim Sun-Mi )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Radiology
강은영 ( Kang Eun-Young )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Surgery
김은규 ( Kim Eun-Kyu )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Surgery
박소연 ( Park So-Yeon )
Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Pathology
Abstract
Purpose: The management of benign intraductal papilloma (IDP) without atypia diagnosed on core needle biopsy (CNB) remains controversial. This study was performed to evaluate the rate of upgrading to malignancy or high-risk lesions after excision and to identify factors associated with upgrading using a large series of benign IDP cases without atypia.
Methods: We included patients who were diagnosed as having benign IDP without atypia on CNB and underwent surgical or vacuum-assisted excision between 2010 and 2015. We analyzed the clinical, radiologic, and histopathologic features of IDPs that were upgraded to malignancy or high-risk lesions after excision.
Results: A total of 511 benign IDPs without atypia diagnosed via CNB were identified, of which 398 cases were treated with excision. After reviewing these cases, four cases of high-risk lesions in adjacent tissue on CNB, two cases which were revealed as papilloma with atypia, and nine cases of malignancy in the same breast were excluded. In the remaining 383 cases, the rate of upgrading to malignancy and high-risk lesions after excision was 0.8% and 4.4%, respectively. The presence of concurrent contralateral breast cancer, the presence of symptoms, and multifocality were factors significantly associated with upgrading to malignancy on subsequent excision. Surgical excision rather than vacuum-assisted excision was significantly associated with upgrading to high-risk lesions or malignancy.
Conclusion: The rate of upgrading to malignancy for benign IDP without atypia was very low, suggesting that close clinical and radiologic observation may be sufficient for patients with benign IDP without atypia on CNB under proper settings.
키워드
Breast neoplasms; Large-core needle biopsy; Observation; Papilloma
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