Vacuum-assisted core biopsy in diagnosis and treatment of intraductal papillomas.

Abstract

BACKGROUND:

The aim of this study was to assess the value of mammographically-guided and ultrasonographically-guided vacuum-assisted core biopsy (VACB) in the diagnosis and treatment of intraductal papillomas of breast and to answer the question of whether biopsy with the Mammotome (Mammotome; Cincinnati, OH) allows the avoidance of surgery in these patients.

PATIENTS AND METHODS:

In the period 2000 to 2010, a total of 1896 vacuum-assisted core biopsies were performed, of which 1183 were ultrasonographically guided and 713 were mammographically guided (stereotaxic).

RESULTS:

In 62 patients (3.2%) histopathologic examination confirmed intraductal papilloma, and in 12 patients (19.4%) atypical lesions were also found. Open surgical biopsy specimens revealed invasive cancer in 2 women these 12 women (false-negative rate, 16.7%; negative predictive value, 83.3%). Biopsy specimens from the remaining 50 patients (80.6%) revealed papilloma without atypia, and further clinical observation and imaging examinations did not show recurrence or malignant transformation of lesions. Hematoma developed in 3 (4.8%) patients as a complication of biopsy; surgical intervention was not required in any of the patients.

CONCLUSION:

VACB is a minimally invasive and efficient method for diagnosing intraductal papilloma of the breast. If histopathologic examination confirms a benign lesion and corresponds to the clinical presentation, surgery may be avoided. However in all cases, histopathologic diagnosis of papilloma with atypical hyperplasia or a suspected malignant lesion in imaging examinations, despite negative biopsy results, should always be an indication for surgical excision.

• Authors: Wojciech Kibil, Diana Hodorowicz-Zaniewska, Tadeusz J Popiela, Jan Kulig
• Journal: Clinical breast cancer (Clin Breast Cancer) Vol. 13 Issue 2 Pg. 129-32 (Apr 2013) ISSN: 1938-0666 [Electronic] United States
• PMID: 23127339 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Biopsy, Needle
• Breast (pathology)
• Breast Neoplasms (diagnosis, surgery)
• Carcinoma, Ductal, Breast (diagnosis, surgery)
• Carcinoma, Lobular (diagnosis, surgery)
• Female
• Follow-Up Studies
• Humans
• Image-Guided Biopsy
• Middle Aged
• Neoplasm Recurrence, Local (diagnosis, surgery)
• Neoplasm Staging
• Papilloma, Intraductal (diagnosis, surgery)
• Prognosis
• Ultrasonography, Mammary
• Vacuum
• Young Adult