Uğur Kılınç Ayşe Nur, Bayramoğlu Zeynep, Ünlü Yaşar, Baran Nahide, Altunkeser Ayşegül, Aksoy Nergis, Eryılmaz Mehmet Ali, Öztürk Yıldırım Elif Nur
Department of Pathology, Konya Training and Research Hospital, Konya, Turkey.
Department of Radiology, Konya Training and Research Hospital, Konya, Turkey.
Eur J Breast Health. 2021 Jun 24;17(3):258-264. doi: 10.4274/ejbh.galenos.2021.6101. eCollection 2021 Jul.
This study aimed to find out valuable parameters that predict the nature of breast papillary lesions before excision, and we compared our results with those in the literature.
We reviewed the medical records and pathology slides of patients diagnosed with papillary neoplasm after undergoing a core-needle biopsy between 2010 and 2020, who, subsequently, underwent surgical excision in a single tertiary care institution. The core biopsy results and pathology results of excision materials were compared with the radiological, pathological, and demographic findings.
A total of 51 patients were included in the study. According to the excision results, the patients were divided into two groups: the atypical group, which included 20 patients (39.3%), and the benign group, which included 31 patients (61.7%). The results of the core biopsy showed that the loss of myoepithelial cell layer was identified in 18 patients in the atypical group, while it was present in all patients in the benign group. Tumor sizes were larger and patient ages were older in the atypical group compared with the benign group. No significant difference was found between atypical and benign groups in terms of breast imaging-reporting and data system (BI-RADS) classification and location (right vs left; central vs peripheral). The upgrade rate was between 0% and 16% in literature, while it was 4% in our study.
There is no consensus on whether patients diagnosed with papillary neoplasia as a result of core biopsy will undergo excision. According to our results, patients with following criteria should have their lesions excised: those who are advanced in age, those who are diagnosed with a papillary lesion as a result of core biopsies with loss of myoepithelial cell layer, and those who are diagnosed with large-sized lesions without loss of myoepithelial cell layer. Patients diagnosed with small-sized lesions without loss of myoepithelial cell layer and who are young in age are to be followed up without the need for lesion excision. The lesions should be adequately sampled.
本研究旨在找出在切除前预测乳腺乳头状病变性质的有价值参数，并将我们的结果与文献中的结果进行比较。
我们回顾了2010年至2020年间在一家三级医疗机构接受粗针活检后被诊断为乳头状肿瘤，随后接受手术切除的患者的病历和病理切片。将粗针活检结果和切除材料的病理结果与放射学、病理学和人口统计学结果进行比较。
本研究共纳入51例患者。根据切除结果，患者分为两组：非典型组，包括20例患者（39.3%）；良性组，包括31例患者（61.7%）。粗针活检结果显示，非典型组18例患者存在肌上皮细胞层缺失，而良性组所有患者均存在肌上皮细胞层。与良性组相比，非典型组的肿瘤尺寸更大，患者年龄更大。非典型组和良性组在乳腺影像报告和数据系统（BI-RADS）分类及位置（右侧与左侧；中央与外周）方面无显著差异。文献中的升级率在0%至16%之间，而我们研究中的升级率为4%。
对于因粗针活检诊断为乳头状肿瘤的患者是否进行切除尚无共识。根据我们的结果，符合以下标准的患者应切除病变：年龄较大者、因粗针活检诊断为肌上皮细胞层缺失的乳头状病变者以及诊断为无肌上皮细胞层缺失的大尺寸病变者。诊断为无肌上皮细胞层缺失的小尺寸病变且年龄较小的患者应进行随访，无需切除病变。病变应进行充分取材。
