Ko Eun Sook, Cho Nariya, Cha Joo Hee, Park Jeong Seon, Kim Sun Mi, Moon Woo Kyung
Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
Korean J Radiol. 2007 May-Jun;8(3):206-11. doi: 10.3348/kjr.2007.8.3.206.
We wanted to assess the need for surgical excising papillary lesions of the breast that were diagnosed upon sonographically guided 14-gauge core needle biopsy.
Sixty-nine women (age range: 25-74 years, mean age: 51.7 years) with 69 papillary lesions (4.9%) were diagnosed and followed after performing sonographically guided 14-gauge core needle biopsies. Surgical excision was performed for 44 (64%) of 69 papillary lesions, and 25 lesions were followed with imaging studies (range: 6-46 months, mean: 17.9 months). The histologic findings upon core biopsy were compared with the surgical, imaging and follow-up findings.
Core needle biopsies of 69 lesions yielded tissue that was classified as benign for 43 lesions, atypical for 18 lesions and malignant for eight lesions. Of the 43 lesions that yielded benign papilloma upon core needle biopsy, one had intraductal papillary carcinoma found upon surgery. An immediate surgical biopsy was recommended for this lesion because of the imaging-histologic discordance. No additional carcinoma was found during the imaging follow-up. Surgical excision was performed for 17 atypical papillary lesions, and this revealed intraductal (n = 6) or invasive (n = 2) papillary carcinoma in 8 (47%) lesions. Of the seven intraductal papillary carcinomas, surgery revealed invasive papillary carcinoma in one (14%).
Our results suggest that papillary lesions of the breast that are diagnosed as benign upon sonographically guided 14-gauge core needle biopsy can be followed when the results are concordant with the imaging findings.
我们想要评估对于在超声引导下经14号粗针穿刺活检确诊的乳腺乳头状病变进行手术切除的必要性。
69名女性（年龄范围：25 - 74岁，平均年龄：51.7岁）有69个乳头状病变（占4.9%），在进行超声引导下经14号粗针穿刺活检后得到诊断并接受随访。69个乳头状病变中的44个（64%）进行了手术切除，25个病变接受影像学检查随访（范围：6 - 46个月，平均：17.9个月）。将粗针穿刺活检的组织学结果与手术、影像学及随访结果进行比较。
69个病变的粗针穿刺活检所获组织中，43个病变分类为良性，18个病变为非典型性，8个病变为恶性。在粗针穿刺活检显示为良性乳头状瘤的43个病变中，有1个在手术时发现为导管内乳头状癌。由于影像学 - 组织学不一致，建议对该病变立即进行手术活检。在影像学随访期间未发现其他癌症。对17个非典型乳头状病变进行了手术切除，其中8个（47%）病变显示为导管内（n = 6）或浸润性（n = 2）乳头状癌。在7个导管内乳头状癌中，手术发现其中1个（14%）为浸润性乳头状癌。
我们的结果表明，对于在超声引导下经14号粗针穿刺活检诊断为良性的乳腺乳头状病变，当结果与影像学表现一致时可进行随访。
