Follow-Up of Breast Papillary Lesion on Needle Core Biopsy: Experience in African-American Population
He Wang, Cyril D'Cruz, Ashhad Mahmood, Patricia Tsang. Newark Beth Israel Medical Center, Newark, NJ
Background: The best clinical follow-up after a needle core biopsy diagnosis of breast papillary lesions remains inconclusive. Our study addresses this question by retrospectively reviewing our experience in a large urban medical center on a primarily African American population.
Design: A search of our medical center's database for breast papillary lesions diagnosed by core needle biopsy between September 2002 and September 2012 was conducted. Cases were reviewed and categorized into benign, atypical and malignant. Immunostains of CK5/6 and CK903 were performed when necessary.
Results: A total of 40 breast papillary lesions were diagnosed on needle core biopsy, including 33 (82.5%) benign papillary lesions, 4 (10%) atypical lesions, and 3 (7.5%) intraductal papillary carcinomas. Of these 40 patients, 14 patients (12 African-Americans, 2 Hispanics) underwent lumpectomy within 6 months after core needle biopsy. Pathology of the lumpectomy showed: 2 of the 11 (18%) benign papillary lesions on needle biopsy were upgraded to intraductal papillary carcinoma; the 2 atypical papillary lesion cases on needle biopsy were both upgraded, one into intraductal papillary carcinoma, the other microinvasive carcinoma; the only case of malignant papillary lesion on core needle biopsy remained as intraductal papillary carcinoma on lumpectomy examination. Combining the benign and atypical papillary lesion cases on needle biopsy, the upgrading rate in the lumpectomy was 29%. As part of this study, immunostains of CK5/6 and CK903 were performed on all four core needle biopsies that were later upgraded to intraductal papillary carcinoma. The diagnosis of only one core could potentially be upgraded into malignant after reviewing immunohistochemical results.
Conclusions: Our results showed in a predominantly African-American population, a large percentage (29%) of benign or atypical breast papillary lesions diagnosed on needle core biopsy will be upgraded in the final excisional examination. Early excision of all papillary lesions diagnosed by core needle biopsy is thus justified in this population.
Monday, March 4, 2013 1:00 PM
Poster Session II # 36, Monday Afternoon