Surgical excision unnecessary in some patients with benign papillomas

Imaging surveillance is an acceptable alternative to surgical excision in patients with benign papilloma, diagnosed at breast core biopsy without cell abnormalities, a new study shows.

The study, conducted at the Breast Health Center of California Pacific Medical Center in San Francisco, included 119 papillomas diagnosed at core without abnormal cells. Imaging follow-up of a minimum of two years without surgical excision was performed on 66 lesions; no cancer was found in this group, said Jessica Leung, MD, FACR, lead author of the study. Surgical excision was done on the remaining 53 lesions, with 50 of those being benign. in situ was diagnosed in the remaining three lesions, she said.

The "histological upgrade rate" (the core biopsy indicated the lesion was benign, but the surgical excision found cancer) was 2.5%, said Dr. Leung. This upgrade rate "approximates the 2% probability of malignancy that is widely accepted for these types of probably ," she said.

"Currently there is disagreement over whether cancer can be reliably excluded by breast core biopsy," said Dr. Leung. "The benefit of surgical excision is definitive tissue diagnosis and exclusion of cancer. The benefit of imaging surveillance is that it obviates unnecessary surgery, with its associated morbidity for nonmalignant lesions," Dr. Leung said. "This study provides evidence that imaging surveillance is appropriate for these patients," said Dr. Leung.

The incidence of benign papillomas without abnormal cells is uncommon --about 1.4% of imaging-guided core biopsies, noted Dr. Leung. Nevertheless, given the total number of core biopsies performed, the number of benign papillomas diagnosed is sufficiently high to warrant an evidence-based approach to their management. are usually histologically complex lesions that are associated with a high degree of , she said.

The study is being presented May 3 at the American Roentgen Ray Society Annual Meeting in Vancouver, Canada.

Related Stories

Recommended for you

Level I trauma experience prepares surgeons for battle

date Jul 01, 2015

Soldiers injured during the conflicts in Iraq and Afghanistan have the highest survival rates in history, thanks to the availability of surgeons skilled in combat care. But combat-ready surgical skills are hard to sustain ...

Surgery may help adolescents with frequent migraines

date Jun 29, 2015

(HealthDay)—Migraine surgery may be an effective choice for adolescents who haven't gotten relief from standard treatment, a small study suggests. The findings were published in the June issue of Plastic an ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.