Breast papillary lesions: an analysis of 70 cases

INTRODUCTION: Papillary breast lesions are rare and constitute less than 10% of benign breast lesions and less than 1% of breast carcinomas. OBJECTIVE: To analyse the clinical presentation, preoperative evaluation, and surgical and anatomopathological characteristics of the patients operated on for papillary breast lesions. MATERIAL AND METHODS: Retrospective descriptive and analytical study. We analysed the database of patients with definitive histopathological diagnosis of papillary breast lesions operated on at our institution from January 2004 to May 2013. RESULTS: During the period described, 70 patients with histopathological diagnosis of papillary breast lesions were operated upon. The median age was 50 years (19–86 years). Thirty-seven patients (52.8%) were symptomatic at diagnosis. Preoperative ultrasound was reported to be altered in all patients. A mammography showed pathologic findings in only 50% of cases. All patients underwent partial mastectomy, after needle localisation under ultrasound, if the lesion was not palpable on physical examination. The final pathological diagnosis was: benign papillary lesion in 55 patients (78.6%) and malignant in 15 patients (21.4%). Adjuvant treatment was performed in all malignant cases. Median follow-up was 46 months (3–115 months). CONCLUSIONS: Patients with papillary breast lesions presented with symptoms in half of all cases. There was a high frequency of malignancy (21.4%), therefore surgical resection was recommended for papillary breast lesions.