Radiologic and Pathologic Correlation for Lactating Adenomas

2021 ◽  
Vol 3 (2) ◽  
pp. 208-214
Author(s):  
Hoiwan Cheung ◽  
Elizabeth U Parker ◽  
Mark R Kilgore ◽  
John R Scheel
Keyword(s):  
Breast Imaging ◽  
Short Interval ◽  
Malignant Potential ◽  
Postpartum Women ◽  
Breast Lesions ◽  
Lactating Women ◽  
Neoplastic Processes ◽  
Imaging Characteristics ◽  
Benign Breast Lesions

Abstract Lactating adenomas are benign breast lesions that occur in pregnant, lactating, and postpartum women. These lesions have no associated malignant potential; their origin is disputed with no consensus on whether they represent hyperplastic or neoplastic processes. On ultrasound, lactating adenomas are classically described as solid, circumscribed, parallel masses with iso/hypoechoic internal echotexture and posterior enhancement. Histologically, lactating adenomas appear as circumscribed nodules of tightly packed lobular acini with extensive lactational change during pregnancy or the postpartum period. Masses in pregnant and lactating women with probably benign imaging characteristics—oval, circumscribed, parallel, iso/hypoechoic—can be managed with short interval follow-up (BI-RADS 3) rather than biopsy. However, lactating adenomas can also demonstrate characteristics that overlap with pregnancy-associated breast cancer, such as margins that are not circumscribed, prompting biopsy to exclude pregnancy-associated carcinoma. Breast imaging radiologists must be aware of the variable appearances of lactating adenomas to appropriately manage pregnant and lactating women presenting with palpable lumps.

scholarly journals Breast Papillary Lesions Diagnosed and Treated using Ultrasound-Guided Vacuum-Assisted Excision

2020 ◽  
Author(s):  
Xiaohui Li ◽  
Hua Gao ◽  
Minling Xu ◽  
Yang Wu ◽  
Dezong Gao
Keyword(s):  
Breast Imaging ◽  
Accurate Diagnosis ◽  
Atypical Hyperplasia ◽  
Breast Lesions ◽  
Ultrasound Images ◽  
Ultrasound Guided ◽  
Linear Probe ◽  
Papillary Lesions ◽  
Low Rate

Abstract Background: The management of papillary lesions of the breast remains controversial, and thus, we assessed the value of vacuum-assisted excision (VAE)-guided ultrasound in the diagnosis and treatment of breast papillary lesions. Methods: We retrospectively reviewed the data of 108 patients with papillary lesions diagnosed using VAE between August 2014 and January 2019. Cases without postoperative breast imaging in the follow-up were excluded, and 85 cases were eligible for the study. The follow-up period ranged from 6 to 53 months, with 38 months on average. All the papillary lesions were located away from the skin or nipple with a size less than or equal to 30 mm, and the lesions categorized as C2-4b were completely excised using VAE. All VAEs were per­formed using an 8-gauge vacuum-assisted biopsy nee­dle under the guidance of ultrasound using a 10 MHz linear probe. Results: Most patients with breast papillary lesions were asymptomatic (56.5%), and when the size of the breast papillary lesion was more than 20 mm on ultrasound imaging, atypical hyperplasia may have been concomitant. Breast lesions might have been pathologically diagnosed as papilloma after biopsy when they were categorized as BI-RADS 4a on ultrasound images. The rate of underestimation was 7.7% in papillary lesions diagnosed with VAE, and the recurrence rate of papilloma after VAE was low. Conclusions: Breast papilloma was a common lesion on ultrasonographic screening, and VAE was applicable for completely excising small papillomas, even papillomas with atypical hyperplasia, to obtain an accurate diagnosis with a low rate of underestimation and recurrence. We believe that papilloma diagnosed by VAE might not require immediate excision, and imaging follow-up may be safe for at least 3 years.

scholarly journals Pure Radial Scars Do Not Require Surgical Excision When Concordant and Benign at Image-guided Breast Biopsy

2021 ◽  
Author(s):  
Maria Piraner ◽  
Kelly D’Amico ◽  
Lawrence L Gilliland ◽  
Mary S Newell ◽  
Michael A Cohen
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Imaging ◽  
Breast Biopsy ◽  
Surgical Excision ◽  
Study Cohort ◽  
Core Needle ◽  
Imaging Characteristics

Abstract Objective To determine the best management option (surgical excision versus imaging surveillance) following the diagnosis of pure radial scars (RSs) and RSs with associated additional high-risk lesions (HRLs) encountered on percutaneous core-needle breast biopsy. Methods An IRB–approved retrospective review of the breast imaging reporting system database was performed to identify all cases of pure RS alone or RS plus an additional HRL (papilloma, atypia, lobular neoplasia) diagnosed on core-needle biopsy, from 2007 to 2016, at four breast centers in our institution. Cases with associated malignancy, discordant radiologic-pathologic results, or those lost to follow-up were excluded. The remaining cases were evaluated to determine results of either subsequent surgical excision or long-term follow-up imaging (minimum of two years). Additional data recorded included clinical presentation, breast density, personal and family history of breast cancer, lesion imaging characteristics, and biopsy method. Results The study cohort included 111 patients with 111 lesions: 56.8% (63/111) with RS alone (pure) and 43.2% (48/111) with RS plus additional HRL(s). Out of the 63 radiologic-pathologic concordant pure RSs, there were no upgrades to malignancy in 51 subsequent surgical excisions or 12 long-term surveillance cases (0/63, 0%). Out of the 48 RSs plus additional HRL(s), there were 2 upgrades to malignancy (2/48, 4.2%). Conclusion Cases of radiologic-pathologic concordant pure RS diagnosed at core-needle biopsy do not require surgical excision. On the other hand, surgical excision should be considered for RS plus additional HRLs diagnosed at core-needle biopsy.

Cryoablation treatment of benign breast lesions with 12-month follow-up

2004 ◽  
Vol 188 (4) ◽  
pp. 340-348 ◽  
Author(s):  
Cary S. Kaufman ◽  
Barbara Bachman ◽  
Peter J. Littrup ◽  
Laurie A. Freeman-Gibb ◽  
Michael White ◽  
...  
Keyword(s):  
Breast Lesions ◽  
Benign Breast Lesions
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