Abstract
Background
Intraductal papilloma (IDP) is well-known as one of the common benign breast lesions
requiring excision. However, treatment of IDP without atypia is controversial. The
aim of our study was to determine the proper management of solitary IDP by core needle
biopsy (CNB).
Patients and Methods
We retrospectively reviewed patients with solitary IDP confirmed by CNB from March
2003 to March 2015. We collected data about final pathology after excision, as well
as clinical, histologic, and radiologic findings at initial diagnosis. The final pathology
was categorized as benign or malignant. We evaluated the rate of upgrade to malignancy
and factors associated with malignancy.
Results
We identified 405 patients who presented benign solitary IDP by CNB. The mean age
was 46.1 years (range, 15-86 years). In total, 135 patients underwent surgical excision,
and 211 underwent vacuum-assisted excision. Of 346 patients, malignant lesions were
found in 8 patients (2.3%): 7 underwent surgical excision, and 1 underwent vacuum-assisted
excision. Only the size of IDP was significantly associated with cancer upgrade (P = .003).
Conclusions
Our study shows that overall malignancy upgrade rate of benign solitary IDP after
excision is very low (2.3%). Even when the size of IDP was less than 1 cm, the upgrade
rate to cancer was only 0.9%. Therefore, for patients with small solitary IDP, we
recommend close follow-up with ultrasound instead of excision.
Keywords
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Article info
Publication history
Published online: March 31, 2017
Accepted:
March 23,
2017
Received in revised form:
March 14,
2017
Received:
December 4,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
