Northwell Health Lenox Hill Hospital, Department of Pathology and Laboratory Medicine, 100 E 77th street, New York, NY, 10075, USA.
Northwell Health Lenox Hill Hospital, Department of Surgery, 100 E 77th street, New York, NY, 10075, USA.
Am J Surg. 2020 Sep;220(3):677-681. doi: 10.1016/j.amjsurg.2020.01.040. Epub 2020 Jan 26.
The aim of the study was to determine the upgrade rate on excision of intraductal papilloma (IDP) without atypia diagnosed on breast core needle biopsy (CNB).
We searched our pathology department database for breast CNB with a diagnosis of IDP from 2013 to 2018. The exclusion criteria included radiologic-pathologic discordance, atypia on the same CNB, absence of histologic slides to review or absence of excision information. Upgrade was defined as ductal carcinoma in situ (DCIS) or invasive cancer identified on excision.
126 IDP without atypia cases from 94 patients were identified. The upgrade rate was 1.58% (2/126). Both upgrade cases showed DCIS with low and intermediate nuclear grade. Histologic size of IDP ≥1 cm was the only statistically significant predictor factor for an upgrade on excision.
The results suggest that non-surgical management of patients with radiologic-pathologic concordant IDP without atypia diagnosed on CNB may be appropriate in routine practice.
本研究旨在确定在乳腺核心针活检（CNB）诊断为非典型性导管内乳头状瘤（IDP）的情况下，切除 IDP 的升级率。
我们在病理科数据库中检索了 2013 年至 2018 年诊断为 IDP 的乳腺 CNB。排除标准包括影像学-病理学不相符、同一次 CNB 出现不典型性、缺乏组织学切片复查或缺乏切除信息。升级定义为切除标本中发现的导管原位癌（DCIS）或浸润性癌。
共确定了 94 例患者的 126 例非典型性 IDP 病例。升级率为 1.58%（2/126）。两个升级病例均显示为低核级和中核级的 DCIS。IDP 的组织学大小≥1cm 是切除时发生升级的唯一具有统计学意义的预测因素。
结果表明，在影像学-病理学一致且 CNB 诊断为非典型性的 IDP 患者中，常规实践中可能适合采用非手术治疗。
