Renshaw Andrew A, Derhagopian Robert P, Tizol-Blanco Dolores M, Gould Edwin W
Department of Pathology, Baptist Hospital of Miami, FL 33176, USA.
Am J Clin Pathol. 2004 Aug;122(2):217-21. doi: 10.1309/K1BN-JXET-EY3H-06UL.
We sought to define the risk associated with papillomas and atypical papillomas in breast core needle biopsy specimens from a series of approximately 8,500 biopsies performed during 8 years. From a total of 62 papillary lesions (including papillomas and atypical papillomas), 40 (65%) had histologic follow-up. Overall, 15 (38%) of 40 patients had ductal carcinoma in situ (12 cases) or invasive carcinoma at excision (3 cases). Eight cases diagnosed as papilloma had benign follow-up. Slides were available for review in 38 cases and reclassified into benign papilloma with florid hyperplasia and no or minimal atypia (18 cases), papilloma with separate foci of atypical ductal hyperplasia (7 cases), and severely atypical papillomas "suspicious" for papillary carcinoma (13 cases). Carcinoma was identified in 0 (0%), 2 (29%), and 12 (92%) cases, respectively. We conclude that while atypical papillary lesions and papillomas with associated atypical ductal hyperplasia in breast core needle biopsy specimens are associated with a risk of carcinoma, lesions diagnosed as papilloma or papilloma with no or minimal atypia are benign and do not need to be excised.
我们试图确定在8年期间进行的一系列约8500例活检的乳腺粗针活检标本中，乳头状瘤和非典型乳头状瘤相关的风险。在总共62例乳头状病变（包括乳头状瘤和非典型乳头状瘤）中，40例（65%）有组织学随访。总体而言，40例患者中有15例（38%）在切除时患有导管原位癌（12例）或浸润性癌（3例）。8例诊断为乳头状瘤的患者随访结果为良性。38例有切片可供复查，并重新分类为伴有 florid 增生且无或仅有轻微异型性的良性乳头状瘤（18例）、伴有非典型导管增生单独病灶的乳头状瘤（7例）以及对乳头状癌“可疑”的严重非典型乳头状瘤（13例）。分别在0（0%）、2（29%）和12（92%）例中发现癌。我们得出结论，虽然乳腺粗针活检标本中的非典型乳头状病变以及伴有相关非典型导管增生的乳头状瘤与癌风险相关，但诊断为乳头状瘤或无或仅有轻微异型性的乳头状瘤是良性的，无需切除。
