TY  - JOUR
A1  - Leithner, Doris
A1  - Kaltenbach, Benjamin
A1  - Hödl, Petra
A1  - Möbus, Volker
A1  - Brandenbusch, Volker
A1  - Falk, Stephan
A1  - Park, Clara
A1  - Vogl, Thomas J.
A1  - Müller-Schimpfle, Markus
T1  - Intraductal papilloma without atypia on image-guided breast biopsy: upgrade rates to carcinoma at surgical excision
T2  - Breast care
N2  - Background: The management of intraductal papilloma without atypia (IDP) in breast needle biopsy remains controversial. This study investigates the upgrade rate of IDP to carcinoma and clinical and radiologic features predictive of an upgrade. Methods: Patients with a diagnosis of IDP on image-guided (mammography, ultrasound, magnetic resonance imaging) core needle or vacuum-assisted biopsy and surgical excision of this lesion at a certified breast center between 2007 and 2017 were included in this institutional review board-approved retrospective study. Appropriate statistical tests were performed to assess clinical and radiologic characteristics associated with an upgrade to malignancy at excision. Results: For 60 women with 62 surgically removed IDPs, the upgrade rate to malignancy was 16.1% (10 upgrades, 4 invasive ductal carcinoma, 6 ductal carcinoma in situ). IDPs with upgrade to carcinoma showed a significantly greater distance to the nipple (63.5 vs. 36.8 mm; p = 0.012). No significant associations were found between upgrade to carcinoma and age, menopausal status, lesion size, microcalcifications, BI-RADS descriptors, initial BI-RADS category, and biopsy modality. Conclusion: The upgrade rate at excision for IDPs diagnosed with needle biopsy was higher than expected according to some guideline recommendations. Observation only might not be appropriate for all patients with IDP, particularly for those with peripheral IDP.
KW  - breast cancer
KW  - imaging
KW  - biopsy
KW  - papilloma
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/51769
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-517695
VL  - 13
IS  - Nr. 5
SP  - 364
EP  - 368
PB  - Karger GmbH
CY  - Freiburg
ER  -