Risk of carcinoma after subsequent excision of benign papilloma initially diagnosed with an ultrasound (US)-guided 14-gauge core needle biopsy: a prospective observational study

Risk of carcinoma after subsequent excision of benign papilloma initially diagnosed with an ultrasound (US)-guided 14-gauge core needle biopsy: a prospective observational study
Jung Min Chang, Woo Kyung Moon, Nariya Cho, Wonshik Han, Dong-Young Noh, In-Ae Park & Eun-Jung Jung
European Radiology 2010; 20;5:1093-1100

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Results:
Of the 114 patients, 87 eventually underwent surgery: among the 100 supposed benign papillomas, surgical excision revealed fibrocystic change or no residual lesion in nine cases, intraductal papilloma in 74, atypical papilloma in 13, papillary ductal carcinoma in situ (DCIS) in three and one invasive papillary carcinoma. The upgrade rate for an atypical papilloma or papilloma with adjacent foci of atypical ductal hyperplasia (ADH) and malignancy was 13% (95% CI = 7.1–21.2%) and 4% (95% CI = 1.1–9.9%), respectively. The mean lesion size (P = 0.041) was significantly larger when lesions were upgraded to malignancy. Other features were not significantly associated with pathological underestimation (P >  0.05).

Conclusion: 
Surgical excision should be considered for benign intraductal papillomas above 1.5 cm in size

Analysis of false-negative results after US-guided 14-gauge core needle breast biopsy

Analysis of false-negative results after US-guided 14-gauge core needle breast biopsy
Ji Hyun Youk, Eun-Kyung Kim, Min Jung Kim, Jin Young Kwak & Eun Ju Son
Eur Radiol (2010) 20: 782–789

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Most false negatives were found immediately and imaging-histological discordance was the most important clue. Careful correlation of clinical, radiological and histological results as well as appropriate follow-up is essential