Di Ai, Abdulwahab M Ewaz, Kevin Van Smaalen, Xiaoxian Li
{"title":"浸润性癌的高升级率使得乳腺乳头状癌的核心针活检的亚分类是不必要的。","authors":"Di Ai, Abdulwahab M Ewaz, Kevin Van Smaalen, Xiaoxian Li","doi":"10.1136/jcp-2025-210259","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Papillary carcinoma diagnosed in core needle biopsy (CNB) refers to carcinoma with papillary features but no definitive invasion, including papillary ductal carcinoma in situ (DCIS), papilloma with DCIS, encapsulated papillary carcinoma (EPC) and solid papillary carcinoma (SPC). This study assesses the upgrade rate of papillary carcinoma in CNB and supports the use of 'papillary carcinoma' as an umbrella term.</p><p><strong>Methods: </strong>A retrospective review identified 41 CNB cases of non-invasive papillary carcinoma with subsequent excision (2011-2018). H&E and immunohistochemistry slides from CNBs were reviewed, and excisional diagnoses were retrieved.</p><p><strong>Results: </strong>All 41 CNB cases were either DCIS or upgraded to invasive carcinoma upon excision, with an overall upgrade rate to invasive carcinoma of 39% (16/41). Subtypes showed varying upgrade rates: 16.7% (1/6) for papillary DCIS, 25% (1/4) for papilloma with DCIS, 83.3% (5/6) for SPC, 100% (1/1) for EPC and 33.3% (8/24) for unclassifiable papillary carcinoma. No lymph node metastases, recurrences or breast cancer-related mortality were observed during the follow-up period.</p><p><strong>Conclusions: </strong>Given the high upgrade rate, subclassification of papillary carcinoma in CNB lacks clinical significance. The term 'papillary carcinoma' should be used in CNB, and lymph node removal warrants further investigation.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"High upgrade rate to invasive carcinoma makes subclassification of papillary carcinoma of the breast in core needle biopsy unnecessary.\",\"authors\":\"Di Ai, Abdulwahab M Ewaz, Kevin Van Smaalen, Xiaoxian Li\",\"doi\":\"10.1136/jcp-2025-210259\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Papillary carcinoma diagnosed in core needle biopsy (CNB) refers to carcinoma with papillary features but no definitive invasion, including papillary ductal carcinoma in situ (DCIS), papilloma with DCIS, encapsulated papillary carcinoma (EPC) and solid papillary carcinoma (SPC). This study assesses the upgrade rate of papillary carcinoma in CNB and supports the use of 'papillary carcinoma' as an umbrella term.</p><p><strong>Methods: </strong>A retrospective review identified 41 CNB cases of non-invasive papillary carcinoma with subsequent excision (2011-2018). H&E and immunohistochemistry slides from CNBs were reviewed, and excisional diagnoses were retrieved.</p><p><strong>Results: </strong>All 41 CNB cases were either DCIS or upgraded to invasive carcinoma upon excision, with an overall upgrade rate to invasive carcinoma of 39% (16/41). Subtypes showed varying upgrade rates: 16.7% (1/6) for papillary DCIS, 25% (1/4) for papilloma with DCIS, 83.3% (5/6) for SPC, 100% (1/1) for EPC and 33.3% (8/24) for unclassifiable papillary carcinoma. No lymph node metastases, recurrences or breast cancer-related mortality were observed during the follow-up period.</p><p><strong>Conclusions: </strong>Given the high upgrade rate, subclassification of papillary carcinoma in CNB lacks clinical significance. The term 'papillary carcinoma' should be used in CNB, and lymph node removal warrants further investigation.</p>\",\"PeriodicalId\":15391,\"journal\":{\"name\":\"Journal of Clinical Pathology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/jcp-2025-210259\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/jcp-2025-210259","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PATHOLOGY","Score":null,"Total":0}
High upgrade rate to invasive carcinoma makes subclassification of papillary carcinoma of the breast in core needle biopsy unnecessary.
Aims: Papillary carcinoma diagnosed in core needle biopsy (CNB) refers to carcinoma with papillary features but no definitive invasion, including papillary ductal carcinoma in situ (DCIS), papilloma with DCIS, encapsulated papillary carcinoma (EPC) and solid papillary carcinoma (SPC). This study assesses the upgrade rate of papillary carcinoma in CNB and supports the use of 'papillary carcinoma' as an umbrella term.
Methods: A retrospective review identified 41 CNB cases of non-invasive papillary carcinoma with subsequent excision (2011-2018). H&E and immunohistochemistry slides from CNBs were reviewed, and excisional diagnoses were retrieved.
Results: All 41 CNB cases were either DCIS or upgraded to invasive carcinoma upon excision, with an overall upgrade rate to invasive carcinoma of 39% (16/41). Subtypes showed varying upgrade rates: 16.7% (1/6) for papillary DCIS, 25% (1/4) for papilloma with DCIS, 83.3% (5/6) for SPC, 100% (1/1) for EPC and 33.3% (8/24) for unclassifiable papillary carcinoma. No lymph node metastases, recurrences or breast cancer-related mortality were observed during the follow-up period.
Conclusions: Given the high upgrade rate, subclassification of papillary carcinoma in CNB lacks clinical significance. The term 'papillary carcinoma' should be used in CNB, and lymph node removal warrants further investigation.
期刊介绍：
Journal of Clinical Pathology is a leading international journal covering all aspects of pathology. Diagnostic and research areas covered include histopathology, virology, haematology, microbiology, cytopathology, chemical pathology, molecular pathology, forensic pathology, dermatopathology, neuropathology and immunopathology. Each issue contains Reviews, Original articles, Short reports, Correspondence and more.
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