Le. Philpotts et al., Uncommon high-risk lesions of the breast diagnosed at stereotactic core-needle biopsy: Clinical importance, RADIOLOGY, 216(3), 2000, pp. 831-837
Citations number
42
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
PURPOSE: To assess the outcome of papillary lesions, radial scars, or lobul
ar carcinoma in situ (LCIS) diagnosed at stereotactic core-needle biopsy (S
CNB).
MATERIALS AND METHODS: Retrospective review of 1,236 lesions sampled with S
CNB yielded 22 papillary lesions, nine radial scars, and five LCIS lesions.
Diffuse lesions such as papillomatosis, papillary ductal hyperplasia, papi
llary ductal carcinoma in situ (DCIS), and atypical lobular hyperplasia wer
e not included. The mammographic findings, associated histologic features,
and outcome were assessed for each case.
RESULTS: Sixteen papillary lesions were diagnosed as benign at SCNB. Of the
se, five were benign at excision, and 10 were unremarkable at mammographic
followup. At excision of an unusual lesion containing a microscopic papilla
ry lesion, DCIS was found. Three of four papillary lesions suspicious at SC
NB proved to be papillary carcinomas; the fourth had no residual carcinoma
at excision. Eight of nine radial scars were excised, which revealed atypic
al hyperplasia in four scars but no malignancies. One LCIS lesion was found
at excision to contain DCIS.
CONCLUSION: Benign or malignant papillary lesions were accurately diagnosed
with SCNB in the majority of cases. Cases diagnosed as suspicious for mali
gnancy or with atypia or unusual associated histologic findings should be e
xcised. No malignancies were found at excision of radial scars diagnosed at
SCNB. Surgical removal of these lesions following SCNB may not be routinel
y necessary. DCIS was found in one lesion diagnosed as LCIS at SCNB, which
suggests that removal of these lesions may be prudent.