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KMID : 1114620130100020153
Journal of the Korean Society for Breast Screening
2013 Volume.10 No. 2 p.153 ~ p.161
Clinicoradiologic Findings Predicting Malignancy in Papillary Lesions of Breast Diagnosed at the US-guided Core-needle Biopsy:In Regard of Complex Echogenicity
Nam Se-Jin

Kim Eun-Kyung
Moon Hee-Jung
Yoon Jung-Hyun
Kim Min-Jung
Abstract
Purpose: To evaluate the clinical and sonographic findings predicting malignancy in papillary lesions of breast diagnosed at the US-guided core-needle biopsy, focusing on complex echogenicity.

Materials and Methods: Retrospective review of our database was performed from January 2003 through January 2010, to identify patients with papillary lesion of breast diagnosed at the US guided core needle biopsy and performed consecutive surgical or US-guided vacuum assisted excision. We included 272 papillary lesions of breast in 251 women (mean age: 46.7¡¾ 10.0 years, mean size: 12.9 ¡¾ 11.1 mm). Of the 272 lesions, 260 (95.6%) had excised by surgery and 12 (4.4%) by US guided vacuum assisted excision. We evaluated clinical and sonographic factors predictive of malignancy.

Results: 203 (74.6 %) were benign and 69 (25.4%) were malignant. Among the 203 benign lesions, 174 (85.7%) were benign papilloma, 29 (14.3%) were atypical papilloma and among the 69 malignant lesions, 44 (63.8%) were non-invasive papillary carcinoma and 25 (36.2%) were invasive papillary carcinoma. 153 (56.25%, 113 benign and 40 malignant) lesions did not show complex echogenicity and 119 (43.75%, 90 benign and 29 malignant) lesions showed complex echogenicity. Palpability (p = 0.019), lesion location (> 2 cm from nipple, p = 0.025) were factors correlated with malignancy in all papillary breast lesion. In 153 non-complex echoic papillary lesion, suspicious irregular shape (p = 0.037), larger diameter (p < 0.001) were more frequently detected in malignant lesion than benign lesion. However, there was no sonographic feature to predict malignancy among the papillary lesions showing complex echogenicity. Only the lesion location (> 2 cm from nipple, p = 0.027) was factor correlated with malignancy in papillary lesion showing complex echogenicity.

Conclusion: The lesion size and irregular sonographic feature are predictive factors for malignancy in the papillary lesion without showing complex echogenicity. However, due to the lack of distinguishable sonographic feature except lesion location, we should pay attention to interpreting image feature of papillary lesion with showing complex echogenicity.
KEYWORD
Ultrasound, Core biopsy, Papillary lesion, Breast, Malignancy
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