Papeix Gabrielle, Zardawi Ibrahim M, Douglas Charles D, Clark David A, Braye Stephen G
The Manning Base Hospital, Taree, N.S.W., Australia.
Acta Cytol. 2012;56(1):41-6. doi: 10.1159/000334391. Epub 2012 Jan 4.
The literature on fine-needle aspiration (FNA) cytology for papillary lesions presents a very mixed picture. Many authors advocate mandatory excision of these lesions. This recommendation is largely based on the 'atypical' nature of the FNA report. The aim of this work is to see if breast papillomas can be treated conservatively.
We report a retrospective study of outcomes for patients with a provisional diagnosis of a 'papillary breast lesion' based on assessment by palpation (no clinically suspicious features), sonography (benign or probably benign according to the Breast Imaging Reporting and Data System 'BI-RADS®'), and FNA (benign cytological category with a papillary architecture) findings from one integrated breast service.
Thirty-six cases were identified over a period of 6 years. Thirty-four of the patients had surgical excision. All of the 34 surgical cases were confirmed to be benign in nature on histopathology (intraduct papilloma). The remaining 2 cases were stable on follow-up.
We believe that a policy of mandatory excision of papillary lesions of the breast is unnecessarily cautious.
关于细针穿刺（FNA）细胞学检查用于乳头状病变的文献呈现出非常复杂的情况。许多作者主张对这些病变进行强制切除。这一建议很大程度上基于FNA报告的“非典型”性质。这项工作的目的是探讨乳腺乳头状瘤是否可以保守治疗。
我们报告了一项回顾性研究，该研究基于触诊评估（无临床可疑特征）、超声检查（根据乳腺影像报告和数据系统“BI-RADS®”为良性或可能为良性）以及来自一个综合乳腺服务机构的FNA（具有乳头状结构的良性细胞学类别）结果，对初步诊断为“乳腺乳头状病变”的患者的治疗结果进行分析。
在6年期间共识别出36例病例。其中34例患者接受了手术切除。所有34例手术病例经组织病理学证实本质上为良性（导管内乳头状瘤）。其余2例在随访中病情稳定。
我们认为，对乳腺乳头状病变进行强制切除的政策过于谨慎。
