NDLI: Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy.

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Outcomes of benign breast papillomas diagnosed at image-guided vacuum-assisted core needle biopsy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hawley, Jeffrey R. Lawther, Hannah Erdal, Barbaros Selnur Yildiz, Vedat O. Carkaci, Selin
Description	Author Affiliation: Hawley JR ( The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Jeffrey.Hawley@osumc.edu.); Lawther H ( The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Hannah.Lawther@osumc.edu.); Erdal BS ( The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Barbaros.Erdal@osumc.edu.); Yildiz VO ( The Ohio State University College of Medicine Department of Biomedical Informatics, 2012 Kenny Road, Columbus, OH 43221. Electronic address: vedat.yildiz@osumc.edu.); Carkaci S ( The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Selin.Carkaci@osumc.edu.)
Abstract	PURPOSE: To determine the upgrade rate of benign papillomas diagnosed at image-guided vacuum-assisted core needle biopsy (VACNB) and to compare our results with the summarized literature. MATERIALS AND METHODS: A database search was performed to identify patients older than 18 years of age with benign papillomas diagnosed at VACNB between 2004 and 2013. A total of 199 papillomas in 184 patients were identified. Clinical, imaging, and pathological features for each were analyzed. Patients who were subsequently diagnosed with malignancy at the site of papilloma, either at surgical excision or upon imaging follow-up, were compared with those not upgraded. Upgrade was defined as a diagnosis of invasive carcinoma or ductal carcinoma in situ (DCIS). RESULTS: Of 199 papillomas, 110 (55.3%) were diagnosed at ultrasound-guided VACNB, 78 (39.2%) were diagnosed at stereotactic-guided VACNB, and 11 (5.5%) were diagnosed at magnetic resonance imaging-guided VACNB. Surgical excision was performed for 89 (44.7%), and the remaining 110 (55.3%) underwent imaging follow-up. Two patients were subsequently diagnosed with invasive carcinoma and 4 were found with DCIS. The upgrade rate across both groups was 3% (6 of 199). Masses with calcifications (P=.001) and smaller needle gauge at VACNB (P=.02) had a significant association with upgrade. CONCLUSION: Benign papillomas diagnosed with VACNB demonstrated a 3% upgrade rate to malignancy, which is similar to the 2.9% upgrade rate calculated by compiling applicable published literature. Conservative management with imaging follow-up as opposed to surgical excision may be appropriate in cases where an initial diagnosis of benign papilloma is made with VACNB. Benign papillomas associated with calcifications on imaging should be considered for surgical excision given their increased association with malignancy.
File Format	HTM / HTML
ISSN	08997071
Issue Number	4
Volume Number	39
e-ISSN	18734499
Journal	Clinical Imaging
Language	English
Publisher	Elsevier
Publisher Date	2015-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Diagnostic Imaging Breast Neoplasms Pathology Breast Papilloma Adult Aged Aged, 80 And Over Biopsy, Large-core Needle Methods Surgery Female Humans Image-guided Biopsy Magnetic Resonance Imaging Middle Aged Retrospective Studies Treatment Outcome Journal Article
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging

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