Clinicopathologic features of papillary lesions on core needle biopsy of the breast predictive of malignancy

Arora, Nimmi; Hill, Chloe; Hoda, Syed A.; Rosenblatt, Ruth; Pigalarga, Rodolfo; Tousimis, Eleni A.

doi:10.1016/j.amjsurg.2007.07.004

« Previous Next »The American Journal of Surgery
Volume 194, Issue 4 , Pages 444-449, October 2007

Clinicopathologic features of papillary lesions on core needle biopsy of the breast predictive of malignancy

Presented at the 8th Annual Meeting of the American Society of Breast Surgeons, Phoenix, AZ, May 2–6, 2007

Nimmi Arora, M.D.
- Department of Surgery, New York Presbyterian Hospital-Cornell, 425 E. 61st St, New York, NY 10021, USA
Chloe Hill, B.S.
- Department of Surgery, New York Presbyterian Hospital-Cornell, 425 E. 61st St, New York, NY 10021, USA
Syed A. Hoda, M.D.
- Department of Pathology, New York Presbyterian Hospital-Cornell, 425 E. 61st St, New York, NY 10021, USA
Ruth Rosenblatt, M.D.
- Department of Radiology, New York Presbyterian Hospital-Cornell, 425 E. 61st St, New York, NY 10021, USA
Rodolfo Pigalarga, M.D.
- Department of Surgery, New York Presbyterian Hospital-Cornell, 425 E. 61st St, New York, NY 10021, USA
Eleni A. Tousimis, M.D.
- Department of Surgery, New York Presbyterian Hospital-Cornell, 425 E. 61st St, New York, NY 10021, USA
- Corresponding author. 425 E. 61st St, 10th Floor, New York, NY 10021. Tel.: +1-212-821-0850; fax: +1-212-821-0765.

Received 30 April 2007; received in revised form 2 July 2007

Abstract

Background

The necessity for surgical excision of papillary lesions identified on percutaneous breast biopsy remains controversial. We reviewed data from patients with papillary lesions found on core needle biopsies to identify features associated with carcinoma.

Methods

A retrospective chart review was performed on patients with papillary lesions diagnosed from image-guided breast biopsies over a 10-year period. Patients had surgical excision or were followed-up radiographically for a 2-year minimum.

Results

Papillary lesions were identified in 154 core needle biopsies. Ninety-five lesions were diagnosed as either benign or atypical. Eighty-nine of these patients had surgical excisions of their lesions. Malignancy was discovered in 22 (25%) of these lesions. Only atypical lesions on biopsy were malignant (P < .005). Forty-six percent of patients age 65 or older were found to have cancer at surgical excision (P < .01).

Conclusions

Papillary lesions found on core needle biopsy frequently harbor malignancy (25%). Atypia and age 65 or older are significant risk factors for malignancy.

Keywords: Papillary lesion, Breast, Atypia, Age, Biopsy, Papilloma