AIM:To ascertain the negative predictive value (NPV) for atypia and malignancy of 14 G core biopsy of papillomas and to determine whether lesion type influences the likelihood of malignancy at lesion excision. MATERIALS AND METHODS:Ninety-six lesions with a 14 G core biopsy diagnosis of benign papilloma without atypia in 95 women were included. The imaging features (mass or microcalcification), biopsy mode, and number of core samples taken were documented. All patients subsequently underwent lesion excision with either extensive vacuum-assisted biopsy (VAB; 72 lesions) or surgery (24 lesions). Mammographic follow-up of at least 2 years was available for 32 lesions that were benign at VAB. RESULTS:Atypia or malignancy was found more commonly in association with microcalcification (six of 29 lesions: 21%; median number of nine 14 G cores) than a mass (five of 67 lesions: 7%; median number of three 14 G cores), although the difference does not reach statistical significance (p = 0.088). The NPV of a 14 G core biopsy diagnosis of papilloma for atypia or malignancy is 89% (85/96). Disease underestimation may be more common in microcalcification lesions despite the greater number of cores obtained. CONCLUSION:Excision (using VAB or surgically) of all papillomas diagnosed as benign on 14 G needle core biopsy is recommended. Surgery may be more appropriate than VAB for some microcalcification lesions unless they are small and can be confidently removed in their entirety using VAB.

译文

目的:确定乳头状瘤14 G核心活检的非典型性和恶性的阴性预测值(NPV),并确定病变类型是否影响切除病变的恶性可能性。
材料与方法:纳入95例经非常规检查,无异型的良性乳头瘤14G核心活检的96处病变。记录了影像学特征(质量或微钙化),活检模式和采集的核心样本数量。随后,所有患者均接受了广泛的真空辅助活检(VAB; 72个病灶)或手术(24个病灶)的病灶切除。对于VAB良性的32个病灶,可以进行至少2年的乳房X光检查。
结果:发现非典型性或恶性肿瘤与微钙化(29个病变中的六个:21%; 9个14G核的中位数)比肿块(67个病变中的7%:7%;三个14G核的中位数)更为常见,尽管差异未达到统计显着性(p = 0.088)。乳头状瘤非典型性或恶性的14 G核心活检诊断的NPV为89%(85/96)。尽管获得的核心数量较多,但疾病低估可能在微钙化病变中更为普遍。
结论:建议在14 G针芯活检中切除所有被诊断为良性的乳头状瘤(使用VAB或手术)。对于某些微钙化病变,手术可能比VAB更合适,除非它们很小并且可以使用VAB完全切除。

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