乳腺导管内乳头状瘤早期管理
Management of Early Breast Intraductal Papilloma
摘要: 随着超声检查和乳腺穿刺组织学检查在乳腺诊疗中日渐普及，对于BI-RADS-3类乳腺肿物中具有潜在恶性风险的病变，早期的识别，早期干预显得尤为重要。其中导管内乳头状瘤(Intraductal papillomas, IPs)是这组疾病中常见的病理类型。随其组织学表现为良性，但IPs具有潜在恶性，并且实际诊疗中易低估其进展为乳腺恶性肿瘤的风险。本文总结、分析了当前文献中对于IPs早期诊断及管理的共识与争议。事实表明，并不一定要向所有IPs患者推荐开放性手术。因此，乳腺外科医生，对于患者的早期识别诊断，对患者的分类管理至关重要。
Abstract: With the popularity of ultrasound and mammary gland puncture biopsy in breast diagnosis and treatment, for BI-RADS-3 kinds of breast neoplasm with the risk of potentially malignant lesions, early identification and early intervention are important. Intraductal papillomas (IPs) are the common pathological types of the group of diseases. With the histological expression it is benign, but IPs are potentially malignant, and it is easy to underestimate the actual diagnosis and treat-ment to the risk of breast malignant tumors. This article summarizes and analyzes the consensus and controversy in current literature for early diagnosis and management of IPs. In fact, does not have to recommend open surgery to all patients with IPs. Therefore, breast surgeon, for early iden-tification of patients with diagnosis, classification management of patients is very important.
文章引用：李童, 李良. 乳腺导管内乳头状瘤早期管理[J]. 临床医学进展, 2022, 12(9): 8559-8562. https://doi.org/10.12677/ACM.2022.1291236

参考文献

[1] Boufelli, G., et al. (2018) Papillomas of the Breast: Factors Associated with Underestimation. European Journal of Can-cer Prevention, 4, 310-314. [Google Scholar] [CrossRef] 
[2] Al Sarakbi, W., Worku, D., Es-cobar, P.F. and Mokbel, K. (2006) Breast Papillomas: Current Management with a Focus on a New Diagnostic and Therapeutic Modality. International Seminars in Surgical Oncology, 3, Article No. 1. [Google Scholar] [CrossRef] [PubMed]
[3] Maxwell, A.J. (2009) Ultrasound-Guided Vacuum-Assisted Excision of Breast Papillomas: Review of 6-Years Experience. Clinical Radiology, 64, 801-806. [Google Scholar] [CrossRef] [PubMed]
[4] Jacobs, T.W., Connolly, J.L. and Schnitt, S.J. (2002) Nonmalignant Lesions in Breast Core Needle Biopsie. The American Journal of Surgical Pathology, 9, 1095-1110. [Google Scholar] [CrossRef] [PubMed]
[5] 狄琳娜. 乳腺导管内乳头状瘤52例临床特征分析及治疗方法个体化选择的意义[J]. 中国医学工程, 2013, 21(10): 118-120.
[6] 崔红, 刘沅林, 陈亮. 超声对导管型乳腺癌与导管内乳头状瘤患者的诊断价值[J]. 分子影像学杂志, 2022, 45(3): 404-407.
[7] Hoda, S.R.K. (2013) World Health Organization (WHO) Classification of Breast Tumours, 4th ed. The American Journal of Surgical Pathol-ogy, 37, 309-310. [Google Scholar] [CrossRef] 
[8] Agoumi, M., Giambattista, J., et al. (2016) Practical Considerations in Breast Papillary Lesions: A Review of the Literature. Archives of Pathology & Laboratory Medicine, 140, 770-790. [Google Scholar] [CrossRef] 
[9] Nakano, S., et al. (2007) Evaluation and Indications of Ultrasound-Guided Vacuum-Assisted Core Needle Breast Biopsy. Breast Cancer, 14, 292-296. [Google Scholar] [CrossRef] [PubMed]
[10] Pareja, F., Corben, A.D., et al. (2016) Breast Intraductal Papillomas with-out Atypia in Radiologic-Pathologic Concordant Core-Needle Biopsies: Rate of Upgrade to Carcinoma at Excision. Can-cer, 122, 2819-2827. [Google Scholar] [CrossRef] [PubMed]
[11] Leithner, D., et al. (2018) Intraductal Papilloma without Atypia on Im-age-Guided Breast Biopsy: Upgrade Rates to Carcinoma at Surgical Excision. Breast Care (Basel), 13, 364-368. [Google Scholar] [CrossRef] [PubMed]
[12] (2016) Consensus Guideline on Concordance Assessment of Im-age-Guided Breast Biopsies and Management of Borderline or High-Risk Lesions.
[13] Rageth, C.J., et al. (2016) First International Consensus Conference on Lesions of Uncertain Malignant Potential in the Breast (B3 Lesions). Breast Cancer Research and Treatment, 159, 203-213. [Google Scholar] [CrossRef] [PubMed]
[14] Mosier, A.D., Keylock, J. and Smith, D.V. (2013) Benign Papil-lomas Diagnosed on Large-Gauge Vacuum-Assisted Core Needle Biopsy which Span < 1.5 cm do Not Need Surgical Excision. The Breast Journal, 19, 611-617. [Google Scholar] [CrossRef] [PubMed]
[15] Chang, J.M., et al. (2011) Papillary Lesions Initially Diagnosed at Ultra-sound-Guided Vacuum-Assisted Breast Biopsy: Rate of Malignancy Based on Subsequent Surgical Excision. Annals of Surgical Oncology, 18, 2506-2514. [Google Scholar] [CrossRef] [PubMed]
[16] Saladin, C., Haueisen, H., et al. (2016) Lesions with Unclear Ma-lignant Potential (B3) after Minimally Invasive Breast Biopsy: Evaluation of Vacuum Biopsies Performed in Switzerland and Recommended Further Management. Acta Radiologica, 57, 815-821. [Google Scholar] [CrossRef] [PubMed]
[17] Shamonki, J., et al. (2013) Management of Papillary Lesions of the Breast: Can Larger Core Needle Biopsy Samples Identify Patients Who May Avoid Surgical Excision. Annals of Sur-gical Oncology, 20, 4137-4144. [Google Scholar] [CrossRef] [PubMed]
[18] Mercado, C.L., Hamele-Bena, D., et al. (2006) Papillary Lesions of the Breast at Percutaneous Core-Needle Biopsy. Radiology, 238, 801-808. [Google Scholar] [CrossRef] [PubMed]
[19] Wen, X. and Cheng, W. (2013) Nonmalignant Breast Papillary Le-sions at Core-Needle Biopsy: A Meta-Analysis of Underestimation and Influencing Factors. Annals of Surgical Oncolo-gy, 20, 94-101. [Google Scholar] [CrossRef] [PubMed]
[20] Nayak, A., et al. (2013) Benign Papillomas without Atypia Diag-nosed on Core Needle Biopsy: Experience from a Single Institution and Proposed Criteria for Excision. Clinical Breast Cancer, 20, 1900-1905. [Google Scholar] [CrossRef] [PubMed]

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