Factors associated with histologic upgrade following surgical excision of breast papillomas: a retrospective multicenter study
Rattachement africain : tr, fi, kz, kh, ag, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
PURPOSE: This study aimed to determine malignant, high-risk, and overall diagnostic upgrade rates after surgical excision of image-guided biopsy-proven intraductal papillomas and to identify factors associated with overall diagnostic upgrade. METHODS: In this retrospective multicenter study, 527 surgically excised papillary lesions from 30 centers were evaluated. Malignant upgrade was defined as malignancy at excision after a biopsy diagnosis of papilloma with or without atypia; high-risk upgrade was defined as a high-risk lesion at excision after papilloma without atypia. Overall diagnostic upgrade comprised either outcome. Multivariable logistic regression assessed age, lesion size, risk status, presence of symptoms, and radiologic-pathologic concordance. RESULTS: Papilloma without atypia accounted for 407 lesions, and papilloma with atypia for 120. The overall malignant upgrade rate was 21.4% (113/527). Among papillomas without atypia, high-risk and malignant upgrade rates were 19.7% (80/407) and 14.2% (58/407), respectively; among papillomas with atypia, malignant upgrade was 45.8% (55/120). Overall diagnostic upgrade occurred in 36.6% (193/527). Multivariable analysis identified older age [odds ratio (OR), 1.03 per year; 95% confidence interval (CI), 1.02-1.05], larger lesion size (OR, 1.02 per mm; 95% CI, 1.00-1.03), presence of symptoms (OR, 1.69; 95% CI, 1.15-2.49), and radiologic-pathologic discordance (concordance OR, 0.54; 95% CI, 0.35-0.84) as independent predictors of upgrade. Microcalcifications (OR, 2.47; 95% CI, 1.27-4.85) and asymmetry (OR, 2.18; 95% CI, 1.12-4.25) on mammography were also significantly associated with upgrade. CONCLUSION: In this retrospective multicenter cohort of surgically excised, biopsy-proven papillary lesions, atypia and several clinical and imaging factors were associated with diagnostic upgrade. These findings may support individualized management decisions in patients with papillary breast lesions. CLINICAL SIGNIFICANCE: Identifying clinical and imaging predictors of upgrade may facilitate risk-adapted management of papillary breast lesions and help avoid unnecessary surgical excision in carefully selected patients.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Factors associated with histologic upgrade following surgical excision of breast papillomas: a retrospective multicenter study
- Date Crossref
- 23/09/2026
- Éditeur
- Galenos Yayinevi
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
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Ege University pays non établi dans la noticeUniversité ou école supérieure
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Trakya University pays non établi dans la noticeUniversité ou école supérieure
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Dokuz Eylül University pays non établi dans la noticeUniversité ou école supérieure
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Ege University, Trakya University et Dokuz Eylül University, avec 9 autres affiliations.
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