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Breast. 2017 Oct;35:42-47. doi: 10.1016/j.breast.2017.06.014. Epub 2017 Jun 22.

Vacuum-assisted complete excision of solid intraductal/intracystic masses and complex cysts: Is follow-up necessary?

Author information

1
Département de radiologie, Hôpital du Saint-Sacrement, CHU de Québec, Université Laval, 1050 chemin Ste-Foy, Québec, G1S 4L8, QC, Canada. Electronic address: vanessa.quinn-laurin.1@ulaval.ca.
2
Axe Oncologie, Centre de Recherche du CHU de Québec, Université Laval, 1050 chemin Ste-Foy, Québec, G1S 4L8, QC, Canada. Electronic address: charles.hogue@crchudequebec.ulaval.ca.
3
Département de radiologie, Hôpital du Saint-Sacrement, CHU de Québec, Université Laval, 1050 chemin Ste-Foy, Québec, G1S 4L8, QC, Canada. Electronic address: pinault.cloutier@gmail.com.
4
Département de radiologie, Hôpital du Saint-Sacrement, CHU de Québec, Université Laval, 1050 chemin Ste-Foy, Québec, G1S 4L8, QC, Canada. Electronic address: nathalie.duchesne@me.com.

Abstract

INTRODUCTION:

Management of complex cysts and benign intraductal/intracystic masses is controversial. The aim of this study was to determine if the complete removal of the complex cyst lesions with ultrasound-guided vacuum-assisted excision (US-VAE) is sufficient for their safe management when the histological diagnosis obtained at biopsy is benign.

SUBJECTS AND METHODS:

This is a single institution retrospective study performed on patients who underwent breast biopsy between April 2007 and September 2013. Patients with complete removal of complex cyst lesion of a BIRADS 4 lesion by US-VAE that obtained a benign diagnosis were included. Size, morphology, histological diagnosis, and surgical or imaging follow-up of the lesions were analyzed.

RESULTS:

During the study period, 131 lesions met the inclusion criteria. Benign papilloma represented 32% (42/131) of the lesions; the remaining lesions had various benign diagnoses. Mean size of the solid mass or the cysts' thickest septum was 7 mm (range, 2-24). Mean imaging follow-up was 34.9 months (24-99 months) in 115 lesions. No recurrence or malignancy in the post-biopsy bed were observed during follow-up. Eleven lesions (8.4%) underwent surgery as follow-up: no cancer was found, but two lesions demonstrated atypia.

CONCLUSIONS:

Complex cyst lesion image completely excised with US-VAE and with a benign histology at biopsy might not require further imaging follow-up or surgery and a return to routine screening can be safely recommended. In a world where healthcare delivery and accessibility is important, elimination of unnecessary follow-ups is pertinent given its lower cost and lesser social impact.

KEYWORDS:

Benign papilloma; Complex cyst; Intracystic mass; Intraductal mass; Vacuum-assisted excision

PMID:
28646723
DOI:
10.1016/j.breast.2017.06.014
[Indexed for MEDLINE]

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