Risk factors for malignancy in benign papillomas of the breast on core needle biopsy.

BACKGROUND

This study was designed to evaluate the clinical and pathologic parameters of benign papillomas diagnosed on core needle biopsy (CNB) and predict malignancy risk after surgical excision.

METHODS

We retrospectively reviewed clinicopathologic findings for 160 CNB-diagnosed benign papillomas followed by surgical excision from 154 patients.

RESULTS

Ten (6.3%) of the excised lesions were diagnosed as malignant. Univariate analysis showed that those that were palpable on physical examination, detected as a mass on mammography, or >1 cm on sonography were significantly associated with malignancy. In multivariate analysis, lesions that were palpable (odds ratio (OR), 29.2; 95% confidence interval (CI), 4.06-209.58; P = 0.001) or detected as a mass (OR, 5.68; 95% CI 1.08-29.87; P = 0.04) remained significantly associated with malignancy. In a CART analysis, including all variables, lesions that were palpable and associated with a mass on mammogram were confirmed as malignant.

CONCLUSIONS

Breast lesions diagnosed as benign papillomas on CNB had a 6.3% risk of being malignant. The risk was highest for lesions that were palpable and detectable as a mass on a mammogram. In addition, the low-risk patients avoid immediate surgical excision, although they should be followed carefully.