Is Further Diagnostic Surgery Necessary for the Benign Papillary Lesions that Are Diagnosed by Large Volume Vacuum Assisted Breast Biopsy?.
10.4048/jbc.2010.13.2.206
- Author:
Hai Lin PARK
1
;
So Yong CHANG
;
Jung Yin HUH
;
Ji Young KIM
Author Information
1. Department of Surgery, Kangnam CHA Hospital, CHA University College of Medicine, Seoul, Korea. phl1@cha.ac.kr
- Publication Type:Original Article
- Keywords:
Benign breast papillary lesions;
Vacuum assisted breast biopsy
- MeSH:
Biopsy;
Biopsy, Large-Core Needle;
Breast;
Follow-Up Studies;
Humans;
Papilloma;
Papilloma, Intraductal;
Recurrence;
Retrospective Studies;
Vacuum
- From:Journal of Breast Cancer
2010;13(2):206-211
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: There is ongoing controversy regarding the management of papillary lesions that are diagnosed by core needle biopsy (CNB). The development of vacuum assisted biopsy now permits non-operative removal of papillary breast lesions. Our aim was to evaluate whether the papillary lesions diagnosed by vacuum assisted breast biopsy (VABB) can be followed up without further diagnostic excision. METHODS: From January 2003 to July 2009, a total of 4,655 US-guided mammotome excision were performed in 3,714 patients at Kangnam CHA Hospital. Out of 4,655 lesions, 156 lesions were proved to be papillary lesions. Among these, 82 lesions that had histologic findings that were consistent with benign papillary lesions and that were followed up for more than 2 years without further diagnostic surgical excision were collected and retrospectively analyzed. Ultrasonographic follow-up was done at 3-6 month intervals to assess for recurrence. The mean follow up period was 49.6 months. RESULTS: The pathologic diagnoses for the 82 lesions obtained via VABB were benign intraductal papilloma and papillomatosis. Half of the lesions were palpable and 50.0% (41 cases) were nonpalpable. Twenty eight lesions (34.1%) were classified as BIRADS category 3, 50 lesions (61.0%) were category 4A, 3 lesions (3.7%) were category 4B and only 1 lesion (1.2%) was category 5 according to the ultrasound exams. No local recurrence developed during the follow up period that needed surgical re-excision or rebiopsy. None of those diagnosed as benign lesions at VABB were upgraded to a more advanced lesions. CONCLUSION: The benign papillary lesions that are diagnosed and excised by mammotome may not need further diagnostic surgical re-excision if surgeons are sure that the targeted lesions were excised completely.
