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An International Multicenter Review of the Malignancy Rate of Excised Papillomatous Breast Lesions.

Abstract：

BACKGROUND:Papillary lesions of the breast are a relatively rare, but heterogeneous group ranging from benign to atypical and malignant. Debate exists regarding the optimal management of these lesions. In the absence of more accurate risk-stratification models, traditional management guidelines recommend surgical excision, despite the majority of lesions proving benign. This study sought to determine the rate of malignancy in excised breast papillomas and to elucidate whether there exists a population in which surgical excision may be unnecessary. METHODS:A multicenter international retrospective review of core biopsy diagnosed breast papillomas and papillary lesions was performed between 2009 and 2013, following institutional ethical approval. Patient demographics, histopathological, and radiological findings were recorded. All data was tabulated, and statistical analysis performed using Stata. RESULTS:A total of 238 patients were included in the final analysis. The age profile of those with benign pathology was significantly younger than those with malignant pathology (p < 0.001). Atypia on core needle biopsy was significantly associated with a final pathological diagnosis of malignancy (OR = 2.73). The upgrade rate from benign core needle biopsy to malignancy on the final pathological sample was 14.4 %; however, only 3.7 % had invasive cancer. CONCLUSIONS:This international dataset is one of the largest in the published literature relating to breast papillomas. The overall risk of malignancy is significantly associated with older age and the presence of atypia on core needle biopsy. It may be possible to stratify higher-risk patients according to age and core needle biopsy findings, thereby avoiding surgery on low-risk patients.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Foley NM,Racz JM,Al-Hilli Z,Livingstone V,Cil T,Holloway CM,Romics L Jr,Matrai Z,Bennett MW,Duddy L,Nofech-Mozes S,Slodkowska E,Mallon EA,Dawson N,Roche T,Relihan N,Hill AD,Redmond HP,Corrigan MA

doi

10.1245/s10434-015-4773-z

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

S385-90

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-015-4773-z

journal_volume

22 Suppl 3

pub_type

杂志文章,多中心研究

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An International Multicenter Review of the Malignancy Rate of Excised Papillomatous Breast Lesions.