Benign Intraductal Papilloma without Atypia on Core Needle Biopsy Has a Low Rate of Upgrading to Malignancy after Excision.
Benign Intraductal Papilloma without Atypia on Core Needle Biopsy Has a Low Rate of Upgrading to Malignancy after Excision.
复制标题
DOI：
10.4048/jbc.2018.21.1.80
复制
发表时间：
2018-03
影响因子：
2.4
通讯作者：
Park SY
中科院分区：
文献类型：
--
作者：
Han SH;Kim M;Chung YR;Yun B;Jang M;Kim SM;Kang E;Kim EK;Park SY
无异型诊断的良性导管内乳头状瘤（IDP）的处理仍然存在争议。本研究的目的是评估切除后升级为恶性或高危病变的比率，并通过大量无异型性的良性IDP病例来确定与升级相关的因素。我们纳入了2010年至2015年间诊断为良性IDP且无CNB非典型性并接受手术或真空辅助切除的患者。我们分析了IDPs在切除后升级为恶性或高危病变的临床、放射学和组织病理学特征。经CNB诊断无异型性的良性IDPs共511例，其中398例行切除治疗。通过对这些病例的回顾，我们排除了4例CNB上邻近组织的高危病变，2例显示为异型性乳头状瘤，以及9例同乳恶性肿瘤。其余383例，术后升级为恶性和高危病变的比例分别为0.8%和4.4%。并发对侧乳腺癌的存在、症状的存在和多灶性是在随后的切除中升级为恶性肿瘤的显著相关因素。手术切除而非真空辅助切除与升级为高危病变或恶性肿瘤显著相关。良性无异型性IDP的恶性转归率很低，提示在适当的条件下，对良性无异型性IDP的CNB患者进行密切的临床和影像学观察是足够的。
The management of benign intraductal papilloma (IDP) without atypia diagnosed on core needle biopsy (CNB) remains controversial. This study was performed to evaluate the rate of upgrading to malignancy or high-risk lesions after excision and to identify factors associated with upgrading using a large series of benign IDP cases without atypia. We included patients who were diagnosed as having benign IDP without atypia on CNB and underwent surgical or vacuum-assisted excision between 2010 and 2015. We analyzed the clinical, radiologic, and histopathologic features of IDPs that were upgraded to malignancy or high-risk lesions after excision. A total of 511 benign IDPs without atypia diagnosed via CNB were identified, of which 398 cases were treated with excision. After reviewing these cases, four cases of high-risk lesions in adjacent tissue on CNB, two cases which were revealed as papilloma with atypia, and nine cases of malignancy in the same breast were excluded. In the remaining 383 cases, the rate of upgrading to malignancy and high-risk lesions after excision was 0.8% and 4.4%, respectively. The presence of concurrent contralateral breast cancer, the presence of symptoms, and multifocality were factors significantly associated with upgrading to malignancy on subsequent excision. Surgical excision rather than vacuum-assisted excision was significantly associated with upgrading to high-risk lesions or malignancy. The rate of upgrading to malignancy for benign IDP without atypia was very low, suggesting that close clinical and radiologic observation may be sufficient for patients with benign IDP without atypia on CNB under proper settings.
登录
查看更多内容
影响因子：
5
作者：
Shin, Hee Jung;Kim, Hak Hee;Gong, Gyungyub
通讯作者：
Gong, Gyungyub
影响因子：
5.6
作者：
Lewis, JT;Hartmann, LC;Visscher, DW
通讯作者：
Visscher, DW
影响因子：
3.9
作者：
Harift, Kaur;Willsher, Peter C.;Saunders, Christobel M.
通讯作者：
Saunders, Christobel M.
影响因子：
3.7
作者：
Cyr, Amy E.;Novack, Deborah;Aft, Rebecca L.
通讯作者：
Aft, Rebecca L.
影响因子：
2.2
作者：
Shiino, Sho;Tsuda, Hitoshi;Kinoshita, Takayuki
通讯作者：
Kinoshita, Takayuki