Ultrasonographic findings of papillary breast lesions with clinical and pathological correlation

Abstract

Introduction: The spectrum of ultrasonographic findings of benign, atypical, and malignant papillary lesions is broad. This study describes the ultrasonographic findings, clinical manifestations, and histopathological correlation of papillary breast lesions in Mexican patients. Material and Methods: We reviewed the pathology database of ultrasound (US)-guided core needle biopsies (CNB) to identify all papillary breast lesions diagnosed between January 2012 and December 2016. US findings were described using the BI-RADS lexicon. Clinical data and histopathologic diagnosis were recorded. Results: Thirty-four papillary breast lesions from 34 women were included. There were 22 (64.7%) benign, 10 (29.4%) atypical, and 2 (5.9%) malignant papillary lesions. The most common clinical presentation was a palpable mass (n = 24, 70.6%); two (5.9%) patients had nipple discharge, while 8 (23.5%) were asymptomatic. The most common ultrasonographic features were an oval shape (n = 18, 53.0%), a not-circumscribed margin (n = 20, 58.8%), parallel orientation (n = 33, 97.0%), a hypoechoic pattern (n = 27, 79.4%), and no posterior features (n = 31, 91.2%). Vascularity (n = 24, 70.6%) and ductal ectasia (n = 4, 11.8%) were associated findings. Calcifications were not observed. The pathological diagnoses of the benign papillary lesions were intraductal papilloma (n = 21, 61.8%) and intraductal papillomatosis (n = 1, 2.9%). Ten (29.5%) atypical papilloma cases were intraductal papilloma with atypical hyperplasia. Intracystic papillary carcinoma (n = 1, 2.9%) and invasive micropapillary carcinoma (n = 1, 2.9%) were the malignant lesions. Conclusion: This study is the first in Mexico that presents the ultrasonographic findings, clinical characteristics, and histopathological correlations of benign, atypical, and malignant papillary breast lesions.