Benign papilloma without atypia diagnosed at US-guided 14-gauge core-needle biopsy: Clinical and US features predictive of upgrade to malignancy

Ji Hyun Youk, Eun Kyung Kim, Jin Young Kwak, Eun Ju Son, Byeong Woo Park, Seung Il Kim

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Abstract

Purpose: To evaluate the diagnostic accuracy of ultrasonographically (US)-guided 14-gauge core-needle biopsy (CNB) for benign papilloma without atypia and to determine whether clinical and radiologic features could be used to predict an upgrade to malignancy. Materials and Methods: This was an institutional review board-approved retrospective study, with a waiver of informed consent. The histologic results of US-guided CNB procedures performed from January 2006 through January 2009 were reviewed. A total of 160 benign papillomas without atypia that were diagnosed at CNB and excised surgically in 143 women (age range, 19-77 years) were assessed. Medical records and sonograms in the women were reviewed. Two radiologists working in consensus correlated imaging findings with the biopsy result to determine concordance. For the upgrade to malignancy after excision, malignant lesions were compared with nonmalignant lesions for the collected clinical and radiologic variables, which included patient age, lesion size, and lesion distance from the nipple, by using the χ2 or Fisher exact test for categoric variables and the Mann-Whitney U test for continuous variables. Results: Eight (5.0%) of 160 papillomas were upgraded to malignancy. Lesions that were 1 cm or larger (seven [11%] of 63) showed a higher upgrade rate than lesions that were smaller than 1 cm (one [1%] of 97) (P =.006). The upgrade rate was higher in patients aged 50 years or older (six [16%] of 37) than in patients younger than 50 years (two [2%] of 123) (P =.002). Lesions that were 3 cm or farther from the nipple (four [13%] of 31) showed a higher upgrade rate than lesions that were less than 3 cm from the nipple (four [3.1%] of 129) (P =.046). Upgrade rates for Breast Imaging Reporting and Data System (BI-RADS) category 3, 4a, 4b, 4c, and 5 lesions were 0%, 2.5%, 6%, 27%, and 25%, respectively (P =.010). Conclusion: At US-guided 14-gauge CNB, benign papilloma without atypia could be diagnosed accurately. Discordance between imaging and pathology results, as well as patient age of 50 years or older, lesion size of 1 cm or greater, lesion distance from the nipple of 3 cm or greater, and BI-RADS category may be helpful in predicting the possibility of upgrade to malignancy.

Original languageEnglish
Pages (from-to)81-88
Number of pages8
JournalRadiology
Volume258
Issue number1
DOIs
Publication statusPublished - 2011 Jan 1

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Large-Core Needle Biopsy
Nipples
Papilloma
Information Systems
Neoplasms
Breast
Research Ethics Committees
Nonparametric Statistics
Informed Consent
Medical Records
Retrospective Studies
Pathology
Biopsy

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{2c200115eeba40cf865fc47d7a1077cd,
title = "Benign papilloma without atypia diagnosed at US-guided 14-gauge core-needle biopsy: Clinical and US features predictive of upgrade to malignancy",
abstract = "Purpose: To evaluate the diagnostic accuracy of ultrasonographically (US)-guided 14-gauge core-needle biopsy (CNB) for benign papilloma without atypia and to determine whether clinical and radiologic features could be used to predict an upgrade to malignancy. Materials and Methods: This was an institutional review board-approved retrospective study, with a waiver of informed consent. The histologic results of US-guided CNB procedures performed from January 2006 through January 2009 were reviewed. A total of 160 benign papillomas without atypia that were diagnosed at CNB and excised surgically in 143 women (age range, 19-77 years) were assessed. Medical records and sonograms in the women were reviewed. Two radiologists working in consensus correlated imaging findings with the biopsy result to determine concordance. For the upgrade to malignancy after excision, malignant lesions were compared with nonmalignant lesions for the collected clinical and radiologic variables, which included patient age, lesion size, and lesion distance from the nipple, by using the χ2 or Fisher exact test for categoric variables and the Mann-Whitney U test for continuous variables. Results: Eight (5.0{\%}) of 160 papillomas were upgraded to malignancy. Lesions that were 1 cm or larger (seven [11{\%}] of 63) showed a higher upgrade rate than lesions that were smaller than 1 cm (one [1{\%}] of 97) (P =.006). The upgrade rate was higher in patients aged 50 years or older (six [16{\%}] of 37) than in patients younger than 50 years (two [2{\%}] of 123) (P =.002). Lesions that were 3 cm or farther from the nipple (four [13{\%}] of 31) showed a higher upgrade rate than lesions that were less than 3 cm from the nipple (four [3.1{\%}] of 129) (P =.046). Upgrade rates for Breast Imaging Reporting and Data System (BI-RADS) category 3, 4a, 4b, 4c, and 5 lesions were 0{\%}, 2.5{\%}, 6{\%}, 27{\%}, and 25{\%}, respectively (P =.010). Conclusion: At US-guided 14-gauge CNB, benign papilloma without atypia could be diagnosed accurately. Discordance between imaging and pathology results, as well as patient age of 50 years or older, lesion size of 1 cm or greater, lesion distance from the nipple of 3 cm or greater, and BI-RADS category may be helpful in predicting the possibility of upgrade to malignancy.",
author = "Youk, {Ji Hyun} and Kim, {Eun Kyung} and Kwak, {Jin Young} and Son, {Eun Ju} and Park, {Byeong Woo} and Kim, {Seung Il}",
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language = "English",
volume = "258",
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Benign papilloma without atypia diagnosed at US-guided 14-gauge core-needle biopsy : Clinical and US features predictive of upgrade to malignancy. / Youk, Ji Hyun; Kim, Eun Kyung; Kwak, Jin Young; Son, Eun Ju; Park, Byeong Woo; Kim, Seung Il.

In: Radiology, Vol. 258, No. 1, 01.01.2011, p. 81-88.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Benign papilloma without atypia diagnosed at US-guided 14-gauge core-needle biopsy

T2 - Clinical and US features predictive of upgrade to malignancy

AU - Youk, Ji Hyun

AU - Kim, Eun Kyung

AU - Kwak, Jin Young

AU - Son, Eun Ju

AU - Park, Byeong Woo

AU - Kim, Seung Il

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Purpose: To evaluate the diagnostic accuracy of ultrasonographically (US)-guided 14-gauge core-needle biopsy (CNB) for benign papilloma without atypia and to determine whether clinical and radiologic features could be used to predict an upgrade to malignancy. Materials and Methods: This was an institutional review board-approved retrospective study, with a waiver of informed consent. The histologic results of US-guided CNB procedures performed from January 2006 through January 2009 were reviewed. A total of 160 benign papillomas without atypia that were diagnosed at CNB and excised surgically in 143 women (age range, 19-77 years) were assessed. Medical records and sonograms in the women were reviewed. Two radiologists working in consensus correlated imaging findings with the biopsy result to determine concordance. For the upgrade to malignancy after excision, malignant lesions were compared with nonmalignant lesions for the collected clinical and radiologic variables, which included patient age, lesion size, and lesion distance from the nipple, by using the χ2 or Fisher exact test for categoric variables and the Mann-Whitney U test for continuous variables. Results: Eight (5.0%) of 160 papillomas were upgraded to malignancy. Lesions that were 1 cm or larger (seven [11%] of 63) showed a higher upgrade rate than lesions that were smaller than 1 cm (one [1%] of 97) (P =.006). The upgrade rate was higher in patients aged 50 years or older (six [16%] of 37) than in patients younger than 50 years (two [2%] of 123) (P =.002). Lesions that were 3 cm or farther from the nipple (four [13%] of 31) showed a higher upgrade rate than lesions that were less than 3 cm from the nipple (four [3.1%] of 129) (P =.046). Upgrade rates for Breast Imaging Reporting and Data System (BI-RADS) category 3, 4a, 4b, 4c, and 5 lesions were 0%, 2.5%, 6%, 27%, and 25%, respectively (P =.010). Conclusion: At US-guided 14-gauge CNB, benign papilloma without atypia could be diagnosed accurately. Discordance between imaging and pathology results, as well as patient age of 50 years or older, lesion size of 1 cm or greater, lesion distance from the nipple of 3 cm or greater, and BI-RADS category may be helpful in predicting the possibility of upgrade to malignancy.

AB - Purpose: To evaluate the diagnostic accuracy of ultrasonographically (US)-guided 14-gauge core-needle biopsy (CNB) for benign papilloma without atypia and to determine whether clinical and radiologic features could be used to predict an upgrade to malignancy. Materials and Methods: This was an institutional review board-approved retrospective study, with a waiver of informed consent. The histologic results of US-guided CNB procedures performed from January 2006 through January 2009 were reviewed. A total of 160 benign papillomas without atypia that were diagnosed at CNB and excised surgically in 143 women (age range, 19-77 years) were assessed. Medical records and sonograms in the women were reviewed. Two radiologists working in consensus correlated imaging findings with the biopsy result to determine concordance. For the upgrade to malignancy after excision, malignant lesions were compared with nonmalignant lesions for the collected clinical and radiologic variables, which included patient age, lesion size, and lesion distance from the nipple, by using the χ2 or Fisher exact test for categoric variables and the Mann-Whitney U test for continuous variables. Results: Eight (5.0%) of 160 papillomas were upgraded to malignancy. Lesions that were 1 cm or larger (seven [11%] of 63) showed a higher upgrade rate than lesions that were smaller than 1 cm (one [1%] of 97) (P =.006). The upgrade rate was higher in patients aged 50 years or older (six [16%] of 37) than in patients younger than 50 years (two [2%] of 123) (P =.002). Lesions that were 3 cm or farther from the nipple (four [13%] of 31) showed a higher upgrade rate than lesions that were less than 3 cm from the nipple (four [3.1%] of 129) (P =.046). Upgrade rates for Breast Imaging Reporting and Data System (BI-RADS) category 3, 4a, 4b, 4c, and 5 lesions were 0%, 2.5%, 6%, 27%, and 25%, respectively (P =.010). Conclusion: At US-guided 14-gauge CNB, benign papilloma without atypia could be diagnosed accurately. Discordance between imaging and pathology results, as well as patient age of 50 years or older, lesion size of 1 cm or greater, lesion distance from the nipple of 3 cm or greater, and BI-RADS category may be helpful in predicting the possibility of upgrade to malignancy.

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