Surgical excision unnecessary in some patients with benign papillomas

May 3, 2012

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

A recipe for long-lasting livers

April 22, 2015

People waiting for organ transplants may soon have higher hopes of getting the help that they need in time. Researchers at the RIKEN Center for Developmental Biology have developed a new technique that extends the time that ...

Surgeon to offer ideas on a way to do human head transplants

February 26, 2015

Sergio Canavero of the Turin Advanced Neuromodulation Group has made it known that he intends to announce at this summer's American Academy of Neurological and Orthopedic Surgeons meeting, that he believes he has put together ...

New tool helps guide brain cancer surgery

July 3, 2014

A tool to help brain surgeons test and more precisely remove cancerous tissue was successfully used during surgery, according to a Purdue University and Brigham and Women's Hospital study.

New imaging technique sharpens surgeons' vision

February 11, 2014

Which superhuman power would you choose for help on the job? For Dr. Julie Margenthaler, it's a technology that brings to mind X-ray vision, used for the first time Monday during an operation to remove a patient's lymph node.

0 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.