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Papillary lesions of the breast at percutaneous core-needle biopsy
Mercado, Cecilia L; Hamele-Bena, Diane; Oken, Shara M; Singer, Cory I; Cangiarella, Joan
PURPOSE: To retrospectively review the imaging and histologic findings in patients in whom a benign papillary lesion was diagnosed at core-needle breast biopsy. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board at each institution; patient consent was not required. The study was HIPAA compliant. The authors reviewed the findings from 42 patients (age range, 26-76 years; mean age, 54.3 years) with 43 benign papillary lesions diagnosed at core-needle biopsy. Thirty-six (84%) of the 43 lesions were surgically excised, and seven (16%) were followed up with long-term imaging. The authors assessed the radiographic findings, the histologic findings at core-needle biopsy, and the findings at subsequent surgical excision or imaging follow-up. Statistical analysis was performed on a per-patient basis and included the Blyth-Still-Casella procedure to construct exact 95% confidence intervals (CIs) and the Fisher exact test. RESULTS: At core-needle biopsy, lesions were diagnosed as papilloma (n = 29), sclerosing papilloma (n = 8), and benign papillary lesions not otherwise specified (n = 6). For the 36 lesions that were surgically excised, histologic follow-up showed no residual lesion in 10, intraductal papilloma in 14, intraductal papillomatosis in two, papilloma with adjacent foci of atypical ductal hyperplasia (ADH) in eight, and well-differentiated papillary ductal carcinoma in situ (DCIS) in two. Mammographic follow-up in the remaining seven lesions revealed stable calcifications in five (at 28-55 months) and no residual lesion in two (at 26-29 months). In nine of the 42 patients (21%), the diagnosis was upgraded to either ADH or DCIS (exact two-sided 95% CI = 11.4%, 36.4%). CONCLUSION: The results strongly suggest that papillary lesions diagnosed as benign at core-needle biopsy should be surgically excised because a substantial number of lesions were upgraded to ADH and DCIS at excision
PMID: 16424237
ISSN: 0033-8419
CID: 63737
Invasive ductal carcinoma with fibrotic focus: mammographic and sonographic findings with histopathologic correlation
Oken, Shara Millman; Mercado, Cecilia L; Memeo, Lorenzo; Hibshoosh, Hanina
OBJECTIVE: We sought to define the imaging findings of invasive ductal carcinoma with fibrotic focus and its associated histopathologic correlation. CONCLUSION: Radiologists should be aware of the imaging characteristics of this newly described entity because of the significant prognostic implications and perhaps to prompt the pathologist to assess for the presence of a fibrotic focus at excision.
PMID: 16037526
ISSN: 0361-803x
CID: 958192
Acquired arteriovenous fistula of the breast [Case Report]
Joseph, Kathie-Ann; Ditkoff, Beth Ann; Komenaka, Ian; Mercado, Cecilia L; Millman, Shara L; Lantis, John; El-Tamer, Mahmoud; Horowitz, Elizabeth; Schnabel, Freya
PMID: 15009046
ISSN: 1075-122x
CID: 79336
An unusual presentation of neurofibromatosis of the breast [Case Report]
Millman, Shara L; Mercado, Cecilia L
Patients with neurofibromatosis type I or von Recklinghausen disease develop neurofibromas in the subcutaneous tissues, including the breast. There are two German reports of massive neurofibromatosis of the breast, but few reports of massive neurofibromatosis of the breast in the English literature. We present an unusual case of neurofibromatosis of the breast with large neurofibromas predominantly noted protruding from both nipple-areolar complexes.
PMID: 14717759
ISSN: 1075-122x
CID: 958162