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Open Access Research

Follow-up of breast papillary lesion on core needle biopsy: experience in African-American population

He Wang1*, Patricia Tsang2, Cyril D’Cruz2 and Kevin Clarke3

Author Affiliations

1 Department of Pathology and Lab Medicine, Temple University School of Medicine, 3401 North Broad Street, Room 350, Philadelphia, PA 19140, USA

2 Department of Laboratory Medicine and Pathology, Newark Beth Israel Medical Center, 201 Lyons Avenue, Newark NA 07112, USA

3 Department of Surgery, Newark Beth Israel Medical Center, 201 Lyons Avenue, Newark NA 07112, USA

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Diagnostic Pathology 2014, 9:86  doi:10.1186/1746-1596-9-86

Published: 24 April 2014

Abstract

Background

The optimal course of clinical follow-up after a diagnosis of breast papillary lesion on a core needle biopsy (CNB) remains elusive. In particular, no reports in literature have addressed this question in African-American population. We describe our experience with breast papillary lesions in a primarily African-American population.

Methods

A search of our database for breast papillary lesions diagnosed on CNB between September 2002 and September 2012 was conducted. Cases were categorized into benign, atypical, and malignant. CK5/6 and CK903 stains were performed when necessary.

Results

A total of 64 breast papillary lesions were diagnosed on CNB, including 55 (86%) benign papillary lesions, 6 (9%) atypical lesions, and 3 (5%) intraductal papillary carcinomas. Of these 64 patients, 29 patients (25 African-Americans, 3 Hispanics, 1 Asian American) underwent lumpectomy within 6 months after CNB. Pathology of the lumpectomy showed: five of the 25 (20%) benign papillary lesions on needle biopsy were upgraded to intraductal or invasive papillary carcinoma; 2 of the 3 atypical papillary lesion cases on core biopsy were upgraded (67%), one into intraductal papillary carcinoma, the other invasive papillary carcinoma; the only case of malignant papillary lesion on CNB remained as intraductal papillary carcinoma on lumpectomy. The rate of upgrade in lumpectomy/mastectomy was 25%. CK5/6 and CK903 immunostains were performed on all seven core needle biopsies that were later upgraded.

Conclusions

In our predominantly African-American urban population, 25% of benign or atypical papillary lesions diagnosed on CNB was upgraded in the final excisional examination. Early excision of all papillary lesions diagnosed on CNB may be justified in this patient population.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7950117821177201 webcite

Keywords:
Breast papillary lesion; Core needle biopsy; Immunostains; African-Americans