Mammotome biopsy in diagnosing and treatment of intraductal papilloma of the breast
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Intraductal papilloma is a benign breast tumor which needs histopathological verification because of the risk of cancer coincidence.The aim of the study was to assess the value of the mammography-guided and ultrasound-guided vacuum-assisted core biopsy in the diagnosis and treatment of intraductal papillomas of breast and to answer the question if mammotome biopsy allows to avoid surgery in these patients.Material and methods. In the period 2000-2011, a total of 2246 vacuum-assisted core biopsies were performed, of which 1495 were ultrasound-guided and 751 were mammography-guided (stereotaxic). In 76/2246 patients (3.4%), aged 19-88 years (mean age was 51,5) histopathological examination confirmed intraductal papilloma.Results. Atypical lesions were accompanying intraductal papilloma in 16/76 cases (21%). Open surgical biopsy performed in these group revealed invasive cancer in 3 women. In all 60 cases (79%) with benign papilloma in biopsy specimens, further clinical observation did not show recurrence or malignant transformation of lesions.Conclusions. Vacuum-assisted core biopsy is a minimally invasive and efficient method used for diagnosing intraductal papilloma of the breast. If histopathological examination confirms a benign character of the lesion, surgery may be avoided but regular follow-up is recommended. However, in all cases histopathological diagnosis of papilloma with atypical hyperplasia, should always be indication for surgical excision.
1 - 04 - 2013
01 - 05 - 2013
- 1. Wei H, Jiayi F, Qinping Z et al.: Ultrasoundguided vacuum-assisted breast biopsy system for diagnosis and minimally invasive excision of intraductal papilloma without nipple discharge. WorldJ Surg 2009; 33: 2579-81.
- 2. Brookes MJ, Bourke AG : Radiological appearances of papillary breast lesions. Clin Radiol 2008; 63:1265-73.[PubMed][Crossref][WoS]
- 3. Maxwell AJ : Ultrasound-guided vacuum-assisted excision of breast papillomas: review of 6-years experience. Clin Radiol 2009; 64: 801-06.[Crossref][WoS]
- 4. Bonaventure T , Cormier B , Lebas P et al.: Benign papilloma: is US-guided vacuum-assisted breast biopsy an alternative to surgical biopsy? J Radiol 2007; 88: 1165-68.[Crossref][WoS]
- 5. Chang J M, Han W, Moon W K et al.: Papillary lesions initially diagnosed at ultrasound-guided vacuum-assisted breast biopsy: rate of malignancy based on subsequent surgical excision. Ann SurgOncol 2011; 18: 2506-14.
- 6. Kil W H, Cho EY, Kim J H et al.: Is surgical excision necessary in benign papillary lesions initially diagnosed at core biopsy? Breast 2008; 17: 258-62.[PubMed][Crossref][WoS]
- 7. Jacobs TW , Connoly J L, Schnitt SJ : Nonmalignant lesions in breast core needle biopsies. Am JSurg Pathol 2002; 26: 1095-1110.[Crossref]
- 8. Richter-Ehrenstein C, Tombokan F, FallenbergEM et al.: Intraductal papillomas of the breast: Diagnosis and management of 151 patients. Breast 2011; 20: 501-04.[WoS][Crossref]
- 9. Liberman L, Cohen MA, Dershaw DD et al.: Atypical ductal hyperplasia diagnosed at stereotaxic core biopsy of breast lesions: an indication for surgical biopsy. AJR Am J Roentgenol 1995; 164: 1111-13.
- 10. Dennis MA, Parker S , Kaske T I et al.: Incidental treatment of nipple discharge caused by benign intraductal papilloma through diagnostic Mammotome biopsy. AJR Am J Roentgenol 2000; 174: 1263-68.
- 11. Sydnor MK, Wilson J D, Hijaz TA et al.: Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy. Radiology 2007; 242: 58-62.[WoS]
- 12. Rizzo M, Lund MJ, Oprea G et al.: Surgical follow-up and clinical presentation of 142 breast papillary lesions diagnosed by ultrasound-guided core-needle biopsy. Ann Surg Oncol 2008; 15: 1040-47.[Crossref][WoS]
- 13. Liberman L, Bracero N, Vuolo MA et al.: Percutaneous large-core biopsy of papillary breast lesions. Am J Roentgenol 1999; 172: 331-37.
- 14. Jaffer S , Nagi C, Bleiweiss IJ: Excision is indicated for intraductal papilloma of the breast diagnosed on core needle biopsy. Cancer 2009; 115: 2837-43.[WoS]
- 15. Youk J H, Kim MJ, Son EJ et al.: Vacuum- Assisted Percutaneous Excision for Management of Benign Papilloma Without Atypia Diagnosed at US-Guided 14-Gauge Core Needle Biopsy. AnnSurg Oncol 2012; 19: 922-28.
- 16. Schueller G , Jaromi S , Ponhold L et al. USguided 14-gauge core needle breast biopsy: results of a validation study in 1352 cases. Radiology 2008; 248: 406-13.[WoS]
- 17. Ashkenazi I, Ferrer K, Sekosan M et al.: Papillary lesions of the breast discovered on percutaneous large core and vacuum-assisted biopsies: reliability of clinical and pathological parameters in identifying benign lesions. Am J Surg 2007; 194: 183-88.[WoS]
- 18. Nakano S , Sakamoto H, Ohtsuka M et al.: Evaluation and indications of ultrasound-guided vacuum- assisted core needle breast biopsy. BreastCancer 2007; 14: 292-96.
- 19. Renshaw AA , Derhagopian R P, Tizol-BlancoDM et al.: Papillomas and atypical papillomas in breast core needle biopsy specimens: risk of carcinoma in subsequent excision. Am J Clin Pathol 2004; 122: 217-21.
- 20. Mercado CL, Hamele-Bena D, Oken S M et al.: Papillary lesions of the breast at percutaneous core-needle biopsy. J. Radiology 2006; 238: 801-08.
- 21. Carder PJ, Khan T , Burrows P et al.: Large volume „mammotome” biopsy may reduce the need for diagnostic surgery in papillary lesions of the breast. J Clin Pathol 2008; 61: 928-33.[WoS]
- 22. Heywang-Köbrunner S H, Heinig A , HellerhoffK et al: Use of ultrasound-guided percutaneous vacuum-assisted breast biopsy for selected difficult indications. Breast J 2009; 15: 348-56.[Crossref][WoS]
- 23. Chun Ying Lui, Hon Shing Lam: Review of Ultrasound-guided Vacuum-assisted Breast Biopsy: Techniques and Applications. J Medl Ultrasound 2010; 18: 1-10.
- 24. Kibil W , Hodorowicz-Zaniewska D, Kulig J : Mammotome biopsy under ultrasound control in the diagnostics and treatment of nodular breast lesions - own experience. Pol Przegl Chir 2012; 84: 242-46.
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