Breast papillary lesions: comparative analysis of core needle biopsy and surgical excision findings in a single-center retrospective cohort with literature review.

Lesiones papilares mamarias: análisis comparativo de los hallazgos de la biopsia con aguja gruesa y de la escisión quirúrgica en una cohorte retrospectiva de un solo centro, con revisión de la literatura.

• Tuba Devrim Izmir Bakircay University, Çiğli Training and Research Hospital, Department of Medical Pathology, Izmir, Turkey. https://orcid.org/0000-0002-5321-2002
• Gamze Erkılınç Izmir Bakircay University, Çiğli Training and Research Hospital, Department of Medical Pathology, Izmir, Turkey. https://orcid.org/0000-0003-4704-7415
• Saniye Sevim Tuncer Ministry of Health, Çiğli Training and Research Hospital, Department of Medical Pathology, Izmir, Turkey. https://orcid.org/0000-0003-0872-7493
• Şaziye Ceren Pehlivan Izmir Bakircay University, Çiğli Training and Research Hospital, Department of Medical Pathology, Izmir, Turkey. https://orcid.org/0009-0002-1514-3648
• Fazilet Uğur Dumant Ministry of Health, Çiğli Training and Research Hospital, Department of Medical Pathology, Izmir, Turkey. https://orcid.org/0000-0002-5721-9746
• Eyup Kebapci Izmir Bakircay University, Çiğli Training and Research Hospital, Department of General Surgery, Izmir, Turkey https://orcid.org/0000-0001-8900-2325

DOI: https://doi.org/10.54817/IC.v67n2a10

Keywords: Papillary breast lesion, Core needle biopsy, Myoepithelial cell, Estrogen receptor, Excision

Abstract

This retrospective study aimed to identify histopathological and immunohistochemical predictors of malignancy requiring surgical excision among papillary breast lesions diagnosed by core-needle biopsy (CNB). Fifty- three women with CNB-diagnosed papillary breast lesions who subsequently underwent surgical excision at the İzmir Bakırçay University Çiğli Hospital be- tween January 2015 and January 2025 were included. Clinical, radiological, and pathological data were analyzed. Twenty-eight patients (52.8%) were ≤50 years of age, and 21 lesions (39.6%) were larger than 3 cm. Surgical excision revealed benign lesions in 24 cases, malignant lesions in 16 cases, and intracystic solid carcinoma or atypical ductal hyperplasia in 13 cases. The malignancy/ atypia group (45.2%) showed a significantly higher frequency of myoepithelial cell loss (p<0.001) and microcalcifications (p=0.028), and uniform, strong estrogen receptor positivity (100%) on CNB. Benign lesions were more commonly peripherally located (p=0.049). No significant associations were observed with age, Breast Imaging Reporting and Data System (BI-RADS) category, or lesion size. These findings indicate that loss of myoepithelial cells and estrogen receptor positivity are strong predictors of malignancy and support the routine incorporation of immunohistochemical evaluation into CNB-based risk stratification.

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