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Papillary Lesions of the Breast Diagnosed at Percutaneous Sonographically Guided Biopsy: Comparison of Sonographic Features and Biopsy Methods

Hee Jung Shin1, Hak Hee Kim1, Sun Mi Kim1, Hye Rin Yang1, Jeong-Hee Sohn1, Gui Young Kwon2 and Gyungyub Gong2

1 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, 388-1 Pungnap-Dong, Songpa-Gu, Seoul 138-376, South Korea.
2 Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea.


Figure 1
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  		Fig. 1A —Multiple papillomas in 51-year-old woman with pain in both breasts. Sonogram of right breast shows irregular-shaped, hypoechoic mass (arrows) with indistinct margins. This lesion was categorized as category 5 according to BI-RADS.

 

Figure 2
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  		Fig. 1B —Multiple papillomas in 51-year-old woman with pain in both breasts. Photomicrograph of excisional biopsy specimen shows papillary mass in lumen of dilated duct. (H and E, original magnification, x200)

 

Figure 3
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  		Fig. 2 —Invasive ductal carcinoma with extensive intraductal component. Sonogram of 46-year-old woman with bloody nipple discharge shows oval-shaped, mixed hyperechoic–hypoechoic lesion (arrows) with indistinct margin in left breast that is not palpable. This lesion was categorized as category 4a according to BI-RADS and sonographically guided core needle biopsy showed intraductal papilloma of small duct type. Surgical excision confirmed lesion was approximately 1.2-cm invasive ductal carcinoma with extensive intraductal component.

 

Figure 4
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  		Fig. 3A —Intraductal papillary carcinoma in 53-year-old woman with palpable mass in left breast. Mammogram shows relatively circumscribed, lobular, hyperdense mass (arrows) in central portion of left breast.

 

Figure 5
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  		Fig. 3B —Intraductal papillary carcinoma in 53-year-old woman with palpable mass in left breast. Sonogram shows relatively circumscribed, complex cystic mass (arrows) with adjacent duct dilatation (arrowheads). This lesion was categorized as category 4a according to BI-RADS and sonographically guided core needle biopsy showed intraductal papilloma. Surgical excision confirmed intraductal papillary carcinoma.

 

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