Objective: To evaluate the surgical outcome of atypical papilloma diagnosed at US-guided 14-gauge core needle biopsy of the breast mass and to determine whether clinical and sonographic features of this lesion could be used to predict an upgrade to malignancy.
Materials and Methods: We reviewed the pathologic results of US-guided 14-gauge core needle biopsy for breast solid masses retrospectively. A total of 27 atypical papillomas diagnosed at this procedure and surgically excised were included in this study. For each lesion, medical records and sonograms were reviewed, and clinical, procedural, and sonographic variables were coded. According to the American College of Radiology BI-RADS, the sonographic features were determined and the assessment category was noted. We compared upgrade rates among the collected variables.
Results: The results of surgical excision in 27 atypical papillomas were malignant in seven (25.9%). For comparison of upgrade rates to malignancy among clinical and procedural variables, no statistically significant differences were found. Also, there was no significant difference among the sonographic characteristics and BI-RADS categories.
Conclusion: A substantial number of atypical papillomas diagnosed at US-guided 14-gauge core needle biopsy were upgraded to malignancy after surgical excision and no clinical, procedural, or sonographic features were documented to predict an upgrade to malignancy. Surgical excision should be recommended for atypical papilloma diagnosed at US-guided 14-gauge core needle biopsy of breast mass.