Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Cancer Prevention and Treatment Center, Peking University Cancer Hospital and Institute, Beijing, China.
Oncol Res Treat. 2018;41(1-2):29-34. doi: 10.1159/000481097. Epub 2018 Jan 22.
The objective of this study was to propose managements for breast papillomas of 10 mm or smaller initially diagnosed at core biopsy.
We reviewed the data of patients in our center from 2004 to 2013. 116 lesions of 10 mm or smaller as measured by ultrasound (US) were diagnosed as papillomas at core needle biopsy (CNB) or vacuum-assisted biopsy (VAB). 74 of the papillomas diagnosed by CNB were surgically excised, the others were followed by imaging surveillance.
13 of 116 lesions were found to be malignant, with an upgrade rate of 11.2%. Analyzing the difference between malignant and nonmalignant lesions, patients with malignant lesions were older than those with nonmalignant lesions (56.6 vs. 46.6 years, p = 0.002). Papillomas with atypia had a significantly higher upgrade rate than without, both in the surgical results (p = 0.030) and overall (p = 0.0392). None of 16 papillomas larger than 5 mm upgraded to malignancy. Breast papillomas diagnosed by CNB had a significantly higher upgrade rate (16.5%) than those diagnosed by VAB (0%) (p = 0.021).
Our finding suggests that breast papillomas of 6-10 mm at initial CNB need additional surgical excision, but imaging surveillance may be suitable for papillomas no larger than 5 mm and papillomas detected by VAB.
本研究旨在提出对初始在核心活检中诊断为 10mm 或更小的乳腺乳头瘤的处理方法。
我们回顾了 2004 年至 2013 年在我们中心的患者数据。超声（US）测量为 10mm 或更小的 116 个病变在核心针活检（CNB）或真空辅助活检（VAB）中被诊断为乳头瘤。74 个在 CNB 诊断为乳头瘤的患者进行了手术切除，其余患者进行了影像学监测。
116 个病变中有 13 个被发现为恶性，升级率为 11.2%。分析恶性和非恶性病变之间的差异，恶性病变患者比非恶性病变患者年龄更大（56.6 岁 vs. 46.6 岁，p=0.002）。有非典型性的乳头瘤的升级率明显高于无非典型性的乳头瘤，手术结果（p=0.030）和总体结果（p=0.0392）均如此。没有一个大于 5mm 的乳头瘤升级为恶性肿瘤。在 CNB 诊断的乳腺乳头瘤的升级率（16.5%）明显高于 VAB 诊断的乳腺乳头瘤（0%）（p=0.021）。
我们的发现表明，在初始 CNB 时为 6-10mm 的乳腺乳头瘤需要额外的手术切除，但对于不超过 5mm 的乳头瘤和 VAB 检测到的乳头瘤，影像学监测可能是合适的。
