Is surgical excision of core biopsy proven benign papillomas of the breast necessary?

Journal Article (Journal Article)

RATIONALE AND OBJECTIVES: The aim of this study was to determine if core biopsy-proven benign papillomas of the breast need to be surgically excised. MATERIALS AND METHODS: Mammographic and pathologic database review from January 1994 to January 2004 revealed 178 papillary lesions diagnosed by core biopsy in 176 women (mean age, 59 years). All lesions had >or=24 months of imaging follow-up (n = 75) or surgical correlation (n = 103). Details regarding core biopsy technique, lesion appearance, pathologic results, imaging-histopathologic concordance, and follow-up imaging were recorded. Core and surgical pathologic results were correlated. RESULTS: Of the 178 papillary lesions diagnosed at core needle biopsy, 120 (67%) were initially diagnosed as benign without atypia. The core biopsy diagnoses of benignity were confirmed for all 120 lesions by either surgical excision (n = 45) or stability after >or=2 years of imaging follow-up (n = 75). Of the remaining 58 papillary lesions, 50 were found to be atypical at core needle biopsy; 15 of those 50 (29%) were upgraded to malignancies at surgical excision. Eight of the 178 lesions (5%) were initially diagnosed as malignant papillary lesions at core needle biopsy. Seven of these eight (88%) were confirmed malignant at excision. None of the surgically proven cancers was diagnosed as benign at core biopsy. CONCLUSIONS: Close imaging follow-up rather than excision of core biopsy-proven benign papillomas was adequate given careful imaging-histopathologic correlation and excision of all atypical and discordant lesions. Individual centers should evaluate their own data and tailor their practices accordingly.

Full Text

Duke Authors

Cited Authors

  • Bennett, LE; Ghate, SV; Bentley, R; Baker, JA

Published Date

  • May 2010

Published In

Volume / Issue

  • 17 / 5

Start / End Page

  • 553 - 557

PubMed ID

  • 20223685

Electronic International Standard Serial Number (EISSN)

  • 1878-4046

Digital Object Identifier (DOI)

  • 10.1016/j.acra.2010.01.001


  • eng

Conference Location

  • United States