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Abstract
Background
There is uncertainty whether benign breast papillomas without atypia (BP) can be followed by imaging or require surgical resection.
MethodsA single-center, retrospective cohort study of patients diagnosed with BP (2011–2021) to determine the upgrade rate on surgery, and factors associated with surgical intervention and upgrade.
Results139 BPs were included. 27(19.4%) had upfront surgery; 112(80.6%) had imaging follow-up. The upfront surgery group had higher rates of pre-excision nipple inversion (n = 2(8.3%)vs.n = 0(0%),p = 0.003). In the imaging group, the median follow-up was 3.8years, and 9 had subsequent resection. Upgrade rate was 5.8%(8/139). Of all BPs undergoing surgery (n = 36), patients ≥60years (75.0%vs.25.0%,p = 0.049) or with family history of breast cancer (87.5%vs.48.1%,p = 0.048) were more likely to have upgrade.
ConclusionsDespite a low number of events, this study supports radiologic follow-up of BP except in patients ≥60 years or with family history of breast cancer, adding to the growing body of evidence supporting watchful waiting of BPs.
Details
1 Faculty of Medicine, McGill University, Montreal. 3605 Rue de la Montagne Décarie, Montreal, Quebec, H3G 2M1, Canada
2 Department of Diagnostic Radiology, McGill University University Health Centre, 1001 Boulevard Décarie, Montreal, Quebec, H4A 3J1, Canada
3 Cedars Breast Clinic, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, Quebec, H4A 3J1, Canada
4 Division of General Surgery, Department of Surgery, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, Quebec, H4A 3J1, Canada
5 Faculty of Medicine, McGill University, Montreal. 3605 Rue de la Montagne Décarie, Montreal, Quebec, H3G 2M1, Canada; Cedars Breast Clinic, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, Quebec, H4A 3J1, Canada; Division of General Surgery, Department of Surgery, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, Quebec, H4A 3J1, Canada