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Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines.

Publication ,  Journal Article
Jee, Y; Bakht, A; Burner, JM; Coldren, DL; Howard-McNatt, M; Chiba, A
Published in: Am Surg
July 2022

BACKGROUND: The recommendation for management of intraductal papilloma has not been clearly established and its surgical excision criteria remain controversial. This study determines the institutional malignancy upstage rate of benign intraductal papillomas and identifies risk factors for upstage. METHODS: Retrospective review was conducted on female patients who were diagnosed with intraductal papillomas without atypia on core needle biopsy at Atrium Health Wake Forest Baptist Hospital between 1/2012 and 6/2021. Patients were excluded if there was a concomitant malignancy or atypia or deemed to be discordant with imaging. Features associated with upstage on imaging and histopathology were obtained from the electronic medical record. RESULTS: This study included 245 intraductal papillomas without atypia in 231 women (mean age, 59.1 ± 12.3 [SD] years). Approximately 31% (76/245) of the papillomas were excised, whereas 69% (169/245) of the papillomas underwent surveillance. Of the patients who underwent excisional biopsy, upstage rate for DCIS was 1.3% (1/76) and 5.3% (4/76) for atypia. All of the papillomas upstaged to DCIS or atypia had lesion size ≥10 mm on imaging. Out of the 139 intraductal papillomas that underwent radiologic surveillance, two (1.4%) developed malignancy and three (2.2%) developed atypia. DISCUSSION: The risk of upstaging of intraductal papilloma without atypia to malignancy remains extremely low. Therefore, routine surgical excision may not be necessary. While the papillomas upstaged to either malignancy or atypia have size abnormality ≥10 mm, other potential selective excision criteria should be explored to further decrease the risk of an upstage.

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Published In

Am Surg

DOI

EISSN

1555-9823

Publication Date

July 2022

Volume

88

Issue

7

Start / End Page

1467 / 1470

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Papilloma, Intraductal
  • Papilloma
  • Middle Aged
  • Humans
  • Female
  • Carcinoma, Intraductal, Noninfiltrating
  • Breast Neoplasms
  • Breast
 

Citation

APA
Chicago
ICMJE
MLA
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Jee, Y., Bakht, A., Burner, J. M., Coldren, D. L., Howard-McNatt, M., & Chiba, A. (2022). Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines. Am Surg, 88(7), 1467–1470. https://doi.org/10.1177/00031348221082276
Jee, Yoonsun, Azad Bakht, Jordan M. Burner, Daniel L. Coldren, Marissa Howard-McNatt, and Akiko Chiba. “Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines.Am Surg 88, no. 7 (July 2022): 1467–70. https://doi.org/10.1177/00031348221082276.
Jee Y, Bakht A, Burner JM, Coldren DL, Howard-McNatt M, Chiba A. Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines. Am Surg. 2022 Jul;88(7):1467–70.
Jee, Yoonsun, et al. “Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines.Am Surg, vol. 88, no. 7, July 2022, pp. 1467–70. Pubmed, doi:10.1177/00031348221082276.
Jee Y, Bakht A, Burner JM, Coldren DL, Howard-McNatt M, Chiba A. Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines. Am Surg. 2022 Jul;88(7):1467–1470.

Published In

Am Surg

DOI

EISSN

1555-9823

Publication Date

July 2022

Volume

88

Issue

7

Start / End Page

1467 / 1470

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Papilloma, Intraductal
  • Papilloma
  • Middle Aged
  • Humans
  • Female
  • Carcinoma, Intraductal, Noninfiltrating
  • Breast Neoplasms
  • Breast