Giant Intraductal Papilloma of Breast

Authors

  • Dalila Vidallé Grupo Oroño Senology Department, Oroño 450, Rosario, Argentina
  • María Eugenia Lucena Grupo Oroño Senology Department, Oroño 450, Rosario, Argentina
  • Sandra Sarancone Grupo Oroño Senology Department, Oroño 450, Rosario, Argentina
  • Encarnación Alonso Grupo Oroño Senology Department, Oroño 450, Rosario, Argentina
  • Cristina Crocco Grupo Oroño Senology Department, Oroño 450, Rosario, Argentina
  • Gabriela Pairola Grupo Oroño Senology Department, Oroño 450, Rosario, Argentina

DOI:

https://doi.org/10.14738/bjhmr.113.16918

Keywords:

Intraductal papilloma, Breast cancer, B3 breast lesions, Underestimation

Abstract

Intraductal papillomas are the most common form of papillary lesions. Despite their benign histological aspect, intraductal papillomas may appear with malignant growths, and a biopsy-based diagnosis involves the risk of underestimating breast cancer. This paper includes a literature review of the most relevant studies published to date in relation to a case of giant intraductal papilloma. Treatment is not consistent and depends on the result of clinical and pathological correlations. Therefore, gynecologists need to distinguish women who may be enrolled in the surveillance program from women requiring additional surgical therapy.

References

Troxell ML, Boulos F, Denkert C, Horii R, Yamaguchi R (2019) Intraductal papilloma. In: WHO classification of tumours editorial board. Breast Tumours, Lyon (France), International Agency for Research on Cancer (WHO classification of tumours series, 5th edn, vol 2), pp 52–56

Agoumi M, Giambattista J, Hayes MM (2016) Practical considerations in breast papillary lesions: a review of the literature. Arch Pathol Lab Med 140:770–790.

Brogi E, Horii R, MacGrogan G, Rakha EA, Troxell ML, Tse M (2019) Papillary neoplasms: introduction. In: WHO classification of tumours editorial board. Breast Tumours, Lyon (France), International Agency for Research on Cancer (WHO classification of tumours series, 5th edn, vol 2), pp 49–52.

Jorns JM (2016) Papillary lesions of the breast: a practical approach to diagnosis. Arch Pathol Lab Med 140:1052–1059.

Wei S (2016) Papillary lesions of the breast: an update. Arch Pathol Lab Med 140:628–643.

Ni YB, Tse GM (2016) Pathological criteria and practical issues in papillary lesions of the breast - a review. Histopathology 68:22–32.

Rakha EA, Ellis IO (2018) Diagnostic challenges in papillary lesions of the breast. Pathology 50:100–110.

Rageth CJ, O’Flynn EAM, Pinker K, Kubik-Huch RA, Mundinger A, Decker T, Tausch C, Dammann F, Baltzer PA, Fallenberg EM, Foschini MP, Dellas S, Knauer M, Malhaire C, Sonnenschein M, Boos A, Morris E, Varga Z (2019) Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res Treat 174:279–296.

Eiada R, Chong J, Kulkarni S, Goldberg F, Muradali D. Papillary lesions of the breast: MRI, ultrasound, and mammographic appearances. AJR Am J Roentgenol. 2012 Feb;198(2):264-71.

Poehls UG, Hack CC, Wunderle M, Renner SP, Lux MP, Beckmann MW, Fasching PA, Nabieva N. Awareness of breast cancer incidence and risk factors among healthy women in Germany: an update after 10 years. Eur J Cancer Prev. 2019 Nov;28(6):515-521.

Kuehner G, Darbinian J, Habel L, et al. Benign papillary breast mass lesions: favorable outcomes with surgical excision or imaging surveillance. Ann Surg On- col 2019; 26:1695–703.

Pareja F, Corben A, Brennan S, et al. Breast intraductal papillomas without atypia in radiologic-pathologic concordant core needle biopsys: Rate of upgrade to carcinoma at excision. Cancer 2016; 122:2819–27.

Tsilimigras DI, Ntanasis-Stathopoulos I, Bakopoulos A, Schizas D, Kalfa M, Karyda I, Papaioannou D, Klapsinou E, Salla C, Sergentanis TN, Moschovi M. Intraductal papilloma of the breast in an 11-year-old male patient: a case report. Pediatr Surg Int. 2017 Jun;33(6):727-730.

Karadeniz E, Arslan S, Akcay MN, Subaşi ID, Demirci E. Papillary Lesions of Breast. Chirurgia (Bucur). 2016 May-Jun;111(3):225-9.

Holley SO, Appleton CM, Farria DM, Reichert VC, Warrick J, Allred DC, Monsees BS. Pathologic outcomes of nonmalignant papillary breast lesions diagnosed at imaging-guided core needle biopsy. Radiology. 2012 Nov;265(2):379-84.

Roy I, Meakins JL, Trembmy G. Giant intraductal papilloma of the breast: a case report. J Surg Oncol. 1985;28(4):281‐283.

Kavolius J, Matsumoto C, Greatorex P, Petermann G. Giant multiple intraductal papilloma of the breast: a case report and review of the literature. Hawaii Med J. 2001;60(3):60‐62. 47

Minoru K, Akira M. Intracystic papilloma of the breast forming a giant cyst. Breast Cancer. 2010; 17:68‐70.

Fatemi Y, Hurley R, Grant C, Henrichsen T, Chen B, Ghosh K. Challenges in the management of giant intraductal breast papilloma. Clinical Case Reports. 2015;3(1):7‐10.

Wang S, Lou J. A case of giant complicated intraductal papilloma of breast on MRI and literature review. Cancer Rep (Hoboken). 2018 Dec;1(4): e1136.

Boecker W, Buerger H, Schmitz K, Ellis IA, van Diest PJ, Sinn HP, Geradts J, Diallo R, Poremba C, Herbst H (2001) Ductal epithelial proliferations of the breast: a biological continuum? Comparative genomic hybridization and high-molecular-weight cytokeratin expression patterns J Pathol 195:415–421.

Mokbel K, Escobar PF, Matsunaga T. Mammary ductoscopy: Current status and future prospects. Eur J Surg Oncol. 2005; 31:3-8.

Lewis JT, Hartmann LC, Vierkant RA, Maloney SD, Pankratz VS, Allers TM, et al. An analysis of breast cancer risk in women with single, multiple, and atypical papilloma. Am J Surg Pathol. 2006; 30:665-72.

Khan S, Diaz A, Archer KJ, Lehman RR, Mullins T, Cardenosa G, et al. Papillary lesions of the breast: To excise or observe? Breast J. 2018; 24:350-5.

Liberman L, Bracero N, Vuolo MA, Dershaw DD, Morris EA, Abramson AF, et al. Percutaneous large-core biopsy of papillary breast lesions. AJR Am J Roentgenol. 1999; 172:331-7.

Bender O, Balci FL, Yu ̈ney E, et al. Scarless endoscopic papillomectomy of the breast. Onkologie 2009; 32:94–8.

Tavassoli FA. Papillary lesions. En: Tavassoli FA, editor. Pathology of the breast. Stamford: Appleton and Lange; 1999. p. 325-72. 8. Hong YR, Song BJ, Jung SS, Kang BJ, Kim SH, Chae BJ. Predictive factors for upgrading patients with benign breast papillary lesions using a core needle biopsy. J Breast Cancer. 2016; 19:410-6.

Han SH, Kim M, Chung YR, Yun BL, Jang M, Kim SM, et al. Benign intraductal papilloma without atypia on core needle biopsy has a low rate of upgrading to malignancy after excision. J Breast Cancer. 2018; 21:80-6.

Wen X, Cheng W. Nonmalignant breast papillary lesions at core- needle biopsy: a meta-analysis of underestimation and influencing factors. Ann Surg Oncol 2013; 20:94–101.

García Gallardo M, Tresserra Casas F, Rodríguez García I, Ara Pérez C. Lesiones papilares intraductales mamarias: nuestra experiencia 2007-2017. Rev Senol Patol Mamar 2020;33(3):88-93.

Ahn SK, Han W, Moon H, et al. Management of benign papilloma without atypia diagnosed at ultrasoundguided core needle biopsy: scoring system for predicting malignancy. Eur J Surg Oncol 2018; 44:53–8.

Cheng T, Chen C, Lee M, et al. Risk factors associated with conversion from nonmalignant to malignant diagnosis after surgical excision of breast papillary lesions. Ann Surg Oncol 2009; 16:3375–9.

Schiaffino, S.; Calabrese, M.; Melani, E.F.; Trimboli, R.M.; Cozzi, A.; Carbonaro, L.A.; Di Leo, G.; Sardanelli, F. Upgrade Rate of Percutaneously Diagnosed Pure Atypical Ductal Hyperplasia: Systematic Review and Meta-Analysis of 6458 Lesions. Radiology 2020, 294, 76–86.

Forester, N.D.; Lowes, S.; Mitchell, E.; Twiddy, M. High Risk (B3) Breast Lesions: What Is the Incidence of Malignancy for Individual Lesion Subtypes? A Systematic Review and Meta-Analysis. Eur. J. Surg. Oncol. 2019, 45, 519–527.

Mann, R.M.; Balleyguier, C.; Baltzer, P.A.; Bick, U.; Colin, C.; Cornford, E.; Evans, A.; Fallenberg, E.; Forrai, G.; Fuchsjäger, M.H.; et al. Breast MRI: EUSOBI Recommendations for Women’s Information. Eur. Radiol. 2015, 25, 3669–3678.

American Society of Breast Surgeons. Consensus guideline on concordance assessment of image-guided breast biopsies and management of borderline or high-risk lesions. Available at: https://www.breastsurgeons.org/docs/statements/ Consensus-Guideline-on-Concordance-Assessment-of-Image-Guided-Breast- Biopsies.pdf? v2.

Choi HY, Kim SM, Jang M, et al. Benign Breast Papilloma without Atypia: Outcomes of Surgical Excision versus US-guided Directional Vacuum-assisted Removal or US Follow-up. Radiology 2019; 293:72–80.

Wu D, Shi AP, Song AL, Fan ZM; Chinese Society of Breast Surgery. Clinical practice guidelines for intraductal papilloma: Chinese Society of breast surgery (CSBrS) practice guidelines 2021. Chin Med J (Engl). 2021 May 19;134(14):1658-1660.

Elfgen C, Leo C, Kubik-Huch RA, Muenst S, Schmidt N, Quinn C, McNally S, van Diest PJ, Mann RM, Bago-Horvath Z, Bernathova M, Regitnig P, Fuchsjäger M, Schwegler-Guggemos D, Maranta M, Zehbe S, Tausch C, Güth U, Fallenberg EM, Schrading S, Kothari A, Sonnenschein M, Kampmann G, Kulka J, Tille JC, Körner M, Decker T, Lax SF, Daniaux M, Bjelic-Radisic V, Kacerovsky-Strobl S, Condorelli R, Gnant M, Varga Z. Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Virchows Arch. 2023 Jul;483(1):5-20.

Ross DS, D’Alfonso TM (2022) Papillary neoplasms of the breast: diagnostic features and molecular insights. Surg Pathol Clin 15(1):133–146.

MacColl C, Salehi A, Parpia S, Hodgson N, Ramonas M, Williams P (2019) Benign breast papillary lesions diagnosed on core biopsy: upgrade rate and risk factors associated with malignancy on surgical excision. Virchows Arch 475(6):701–707.

Nakhlis F, Baker GM, Pilewskie M, Gelman R, Calvillo KZ, Lud- wig K et al (2021) The incidence of adjacent synchronous invasive carcinoma and/or ductal carcinoma in situ in patients with intra- ductal papilloma without atypia on core biopsy: results from a prospective multi-institutional Registry (TBCRC 034). Ann Surg Oncol 28(5):2573–2578

Ni Y, Tse GM (2022) Papillary lesions of the breast - review and practical issues. Semin Diagn Pathol 39(5):344–354.

Catanzariti F, Avendano D, Cicero G, et al. High-risk lesions of the breast: concurrent diagnostic tools and management recommendations. Insights Imaging 2021; 12:63.

Pham T, Raghavendra U, Koh JEW, et al. Development of breast papillary index for differentiation of benign and malignant lesions using ultrasound images. J Ambient Intelligence Humanized Comput 2021; 12:2121–9.

Castells X, Domingo L, Corominas JM, et al. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast dis- ease: a study from a population-based screening program. Breast Cancer Res Treat 2015; 149:237–44.

Alberty-Oller JL, Reyes S, Moshier E, et al. Does previous history of cancer or atypia predict histologic upgrade for pure intraductal papillomas diagnosed via core biopsy? A study of 490 cases at a single institution. Cancer Rep 2022;5: e1481.

Yamaguchi R, Tanaka M, Tse GM, Yamaguchi M, Terasaki H, Hirai Y, et al. Management of breast papillary lesions diagnosed in ultrasound-guided vacuum-assisted and core needle biopsies. Histopathology 2015; 66:565–576. 49

Kiran S, Jeong YJ, Nelson ME, Ring A, Johnson MB, Sheth PA, Ma Y, Sener SF, Lang JE. Are we overtreating intraductal papillomas? J Surg Res. 2018 Nov; 231:387-394.

Tran HT, Mursleen A, Mirpour S, Ghanem O, Farha MJ. Papillary Breast Lesions: Association with Malignancy and Upgrade Rates on Surgical Excision. Am Surg. 2017 Nov 01;83(11):1294-1297.

Wang WY, Wang X, Gao JD, Wang J, Liu JQ, Wang X, Zhao DB. [Analysis of the clinicopathological characteristics and prognosis in 674 cases of breast intraductal papillary tumor]. Zhonghua Zhong Liu Za Zhi. 2017 Jun 23;39(6):429-433.

Chen Y, Mack J, Karamchandani D, et al. Excision recommended in high-risk patients: revisiting the diagnosis of papilloma on core biopsy in the context of patient risk. Breast J 2019; 25:232–6.

Kulka J, Madaras L, Floris G. Papillary lesions of the breast. Virchows Archive 2022; 480:1.

Downloads

Published

2024-05-16

How to Cite

Vidallé, D., Lucena, M. E., Sarancone, S., Alonso, E., Crocco, C., & Pairola, G. (2024). Giant Intraductal Papilloma of Breast. British Journal of Healthcare and Medical Research, 11(3), 36–50. https://doi.org/10.14738/bjhmr.113.16918