US-Guided Vacuum-Assisted Percutaneous Excision for Management of Benign Papilloma Without Atypia Diagnosed at US-Guided 14-Gauge Core Needle Biopsy
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To assess the diagnostic accuracy of ultrasound (US)-guided vacuum-assisted excision (VAE) for the postbiopsy management of benign papilloma without atypia after US-guided 14-gauge core needle biopsy (CNB).
This was an institutional review board–approved retrospective study, with a waiver of informed consent. After a review of the histologic results and postbiopsy management of US-guided CNB performed from January 2007 through April 2009, 122 benign papillomas without atypia were diagnosed at CNB and excised percutaneously with US-guided VAE. Among them, a total of 67 papillomas having surgical excision (n = 5) or at least 2 years’ US follow-up (n = 62) after VAE were enrolled onto this study. We reviewed the medical records, US findings, and pathologic results obtained before and after VAE. Over the follow-up period, whether any malignancy at the site of the VAE was diagnosed was evaluated.
The pathologic results of 67 VAEs were benign in 63 (94%) and atypical in four (6%). None of 63 benign lesions proved to be malignant after surgical excision (n = 1) or US follow-up (n = 62). Of four atypical lesions, however, one was upgraded to ductal carcinoma-in-situ (25%) after surgical excision. Of 62 benign VAE results having US follow-up, 56 (90.3%) showed no residual lesion at the site of the VAE.
For the postbiopsy management of benign papilloma without atypia after US-guided CNB, US-guided VAE was accurate and could be alternative to surgery. In cases of diagnosis of atypical lesion at VAE, however, surgery should be performed for a definitive diagnosis.
KeywordsCore Needle Biopsy Nipple Discharge Residual Lesion Papillary Lesion Lobular Neoplasia
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2009-0067048).
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