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Papillary lesions of the breast diagnosed by core needle biopsy: 71 cases with surgical follow-up
The American Journal of Surgery, 04/02/09

Bernik SF et al. – Study reports that when a core biopsy of a papillary lesion is encountered, there is a strong likelihood of discovering atypia or malignancy in the index lesion or in close proximity. Therefore, surgical excision should be performed to avoid missing a malignancy and to allow for accurate breast cancer risk assessment that can impact survival and decisions regarding chemoprevention.

• Study to assess the adequacy of core needle biopsy (CNB) in evaluating papillary breast lesions
• 122 papillary lesions diagnosed by CNB were identified in the database
• Study population consisted of 71 papillary lesions that were subsequently surgically excised

• Of the 71 papillary lesions excised –
  • 8 were malignant
  • 13 were atypical - 7 lesions (54%) were associated with malignancy upon excision
  • 47 were benign at the time of CNB - 13 (28%) revealed atypia and 4 (9%) revealed malignancy upon surgical excision
• Slightly over half the upgrades were due to finding atypia or malignancy in the tissue surrounding the papillary lesion
• The total rate of upgrades from the CNB diagnosis to the excisional diagnosis was 38%

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