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Clinical and imaging characteristics of benign and atypical papillary lesions diagnosed on core biopsy
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Background
Papillary lesions of the breast constitute a heterogeneous group ranging from non-malignant papillomas to papillary carcinoma. While surgical excision is recommended for atypical papilloma or papillary DCIS/ carcinoma on core biopsy, controversy persists in the management of benign papillomas which are diagnosed with core needle biopsy (...
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Citations
... The treatment of benign and atypical papilloma is being evolved. The surgical excision of all papillary lesions is recommended for definitive diagnosis and standard management for malignant papillary lesions [24,30]. Li X et al. suggested the vacuum assisted excision is applicable for complete excision of small papillomas, even papillomas with atypical hyperplasia [31]. ...
... Accurate results and coordination between a trained radiologist and pathology are of utmost importance in the decision making between follow-up or surgery [35]. However, Fatima K et al. have observed no reliable clinical or imaging features that can pre-surgically predict atypical upgradation or malignant potential [30]. Tokiniwa H and fellows detected surgical excision advantageous for papillary lesions especially for the lesions located far from the nipple [36]. ...
Papillary neoplasm of breast comprises of seven separate heterogeneous entities ranging from benign, atypical and malignancy including non-invasive and invasive carcinoma. Papillary carcinoma (PC) is seen more commonly in older postmenopausal women with favorable prognosis. PC breast typically presents with bloody nipple discharge and an abnormal mass with radiologic features of intraductal mass. Encapsulated PC and solid PC is to be treated as in situ carcinoma, but distinction of invasive PC from non invasive carcinoma is critical both at microscopic and molecular level. So, surgical excision should be the choice of definitive diagnostic technique in papillary neoplasm instead of core needle biopsy. Furthermore, treatment guidelines for invasive PC also have been framed, but incidence of recurrence and death attributable to various subtypes of carcinoma remained same. So, this is important topic to be addressed to understand the need for further management and outcome of the disease.
