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Factors associated with upgrade, malignant upgrade, and subsequent breast cancer occurrence of papillary breast lesions diagnosed on core needle biopsy.

AIM
In this study, we analyzed the upgrade rate and associated factors for upgrade, malignant upgrade, and subsequent breast cancer occurrence of papillary breast lesions diagnosed on core needle biopsy (CNB).


METHODS
One hundred sixty-nine patients who underwent surgery for the treatment of papillary breast lesions diagnosed on CNB were included in this study. Medical records including radiological and pathological reports were retrospectively reviewed.


RESULTS
The overall upgrade rate was 29.6%, and upgrade rate to malignancy was 16.6%. Age over 45 years, preoperative tumor size ≥0.7 cm on breast ultrasound, pathologic tumor size ≥0.4 cm, breast imaging reporting and data system (BIRADS) category 4b or 4c, and personal history of breast cancer were associated with upgrade. In addition, age over 45 years, preoperative tumor size ≥0.9 cm, pathologic tumor size ≥0.6 cm, atypia in CNB, and BIRADS category 4b or 4c were associated with malignancy. The risk of subsequent breast cancer occurrence was increased in preoperative tumor size ≥0.8 cm, pathologic tumor size ≥0.5 cm, multiple and recurrent lesions.


CONCLUSION
Our study showed high upgrade rate of papillary breast lesions diagnosed on CNB. Our findings suggest that surgical excision is recommended for papillary breast lesions diagnosed on CNB in selected patients.