Abstract:

Objective: The goals of this study were first to evaluate the radiology and histopathology findings of patients diagnosed with intraductal lesions and who had undergone biopsies. The second objective was to investigate the surgery requirements in those cases diagnosed with intraductal papilloma (IDP) postoperatively. Material and Methods: Patients diagnosed with intraductal papillary lesions and who then underwent biopsy were retrospectively reviewed. An ultrasound (US) was performed on all patients, if required; a mammography (MMG) and Magnetic resonance imaging (MRI) was also performed on patients. A Tru-cut biopsy or fine needle aspiration biopsy (FNAB) was performed on patients. Atipia, any discordance between the radiology and pathology findings, risk factors and patient requests were taken into account for deciding on surgical excision. Results: Of the seventy-three patients included in the study, 59 of them were ≥40 years. An ultrasound was performed on all patients, an MMG was performed on the 59 patients ≥40 years, and an MRI was performed on 8 patients. FNAB was performed on 11 patients, IDP was diagnosed in one of them, a tru-cut biopsy was performed on 40 patients and 10 of them were diagnosed with IDP. Three injuries were histopatologically malignant and 5 injuries were pre-invasive or pre-neoplastic in 22 of the patients who underwent surgical resection. Conclusion: There is still no consensus on the management of patients diagnosed with benign papillary lesions after Tru-cut biopsy or FNAB. Lesions with atipia usually underwent surgical resection due to their malignant potential. Recent studies showed an upgrade in one-fifth of the patients' histopathological results and the treatment strategy was shifted in favour of surgery. In our series, the upgrade rate was 10.9%, which is similar to the literature. Imaging studies in patients diagnosed with papillary lesions should be evaluated carefully, and in the case of discordance between radiology and histopathology, total excision should be considered.

Keywords:

Abstract:

Objective: The aims of this study were firstly to evaluate the radiology and histopathology findings of patients diagnosed with intraductal lesions and who had undergone biopsies. The second objective was to investigate the surgery requirements in those cases diagnosed with intraductal papilloma (IDP) post operatively. Material and Methods: Patients diagnosed with intraductal papillary lesions and who then underwent biopsy were retrospectively reviewed. An ultrasound (US) was performed on all patients, if required; a mammography (MMG) and Magnetic resonance imaging (MRI) was also performed on patients. A Tru-cut biopsy or fine needle aspiration biopsy (FNAB) was performed on patients. Atipia, any discordance between the radiology and pathology findings, risk factors and patient requests were taken into account for deciding on surgical excision. Results: Of the seventy-three patients included in the study, 59 of them were ≥40 years. An ultrasound was performed on all patients, an MMG was performed on the 59 patients ≥40 years, and an MRI was performed on 8 patients. FNAB was performed on 11 patients, IDP was diagnosed in one of them, a tru-cut biopsy was performed on 40 patients and 10 of them were diagnosed with IDP. Three lesions were histopatologically malignant and 5 lesions were pre-invasive or pre-neoplastic in 22 of the patients who underwent surgical resection. Conclusion: There is still no consensus on the management of patients diagnosed with benign papillary lesions after Tru-cut biopsy or FNAB. Lesions with atipia usually underwent surgical resection due to their malignant potential. Recent studies showed an upgrade in one-fifth of the patients’ histopathological results and the treatment strategy was shifted in favor of surgery. In our series, the upgrade rate was 10.9 % which is similar to the literature. Imaging studies in patients diagnosed with papillary lesions should be evaluated carefully, and in the case of discordance between radiology and histopathology, total excision should be considered.