{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:31:52Z","timestamp":1777447912978,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The recommendation for management of intraductal papilloma has not been clearly established and its surgical excision criteria remain controversial. This study determines the institutional malignancy upstage rate of benign intraductal papillomas and identifies risk factors for upstage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review was conducted on female patients who were diagnosed with intraductal papillomas without atypia on core needle biopsy at Atrium Health Wake Forest Baptist Hospital between 1\/2012 and 6\/2021. Patients were excluded if there was a concomitant malignancy or atypia or deemed to be discordant with imaging. Features associated with upstage on imaging and histopathology were obtained from the electronic medical record.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 245 intraductal papillomas without atypia in 231 women (mean age, 59.1 \u00b1 12.3 [SD] years). Approximately 31% (76\/245) of the papillomas were excised, whereas 69% (169\/245) of the papillomas underwent surveillance. Of the patients who underwent excisional biopsy, upstage rate for DCIS was 1.3% (1\/76) and 5.3% (4\/76) for atypia. All of the papillomas upstaged to DCIS or atypia had lesion size \u226510\u00a0mm on imaging. Out of the 139 intraductal papillomas that underwent radiologic surveillance, two (1.4%) developed malignancy and three (2.2%) developed atypia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The risk of upstaging of intraductal papilloma without atypia to malignancy remains extremely low. Therefore, routine surgical excision may not be necessary. While the papillomas upstaged to either malignancy or atypia have size abnormality \u226510\u00a0mm, other potential selective excision criteria should be explored to further decrease the risk of an upstage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348221082276","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T09:48:27Z","timestamp":1649929707000},"page":"1467-1470","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines"],"prefix":"10.1177","volume":"88","author":[{"given":"Yoonsun","family":"Jee","sequence":"first","affiliation":[{"name":"Atrium Health Wake Forest Baptist, Winston Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azad","family":"Bakht","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist, Winston Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan M.","family":"Burner","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist, Winston Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel L.","family":"Coldren","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist, Winston Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa","family":"Howard-McNatt","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist, Winston Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Chiba","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist, Winston Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"bibr1-00031348221082276","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12073"},{"key":"bibr2-00031348221082276","doi-asserted-by":"publisher","DOI":"10.1159\/000074643"},{"key":"bibr3-00031348221082276","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.164.2.7839962"},{"key":"bibr4-00031348221082276","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.159.3.1503011"},{"key":"bibr5-00031348221082276","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800014"},{"key":"bibr6-00031348221082276","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200209000-00001"},{"key":"bibr7-00031348221082276","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2018.04.021"},{"key":"bibr8-00031348221082276","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.04.007"},{"key":"bibr9-00031348221082276","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2421031988"},{"key":"bibr10-00031348221082276","volume-title":"Consensus guideline on concordance assessment of image guided breast biopsies and management of borderline or high risk lesions","volume":"2016","author":"American Society of Breast Surgeons","year":"2022"},{"key":"bibr11-00031348221082276","volume":"2021","author":"Bevers TB","year":"2018","journal-title":"J Natl Compr Canc Netw"},{"key":"bibr12-00031348221082276","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.21.25832"}],"container-title":["The American Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348221082276","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348221082276","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348221082276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:36:14Z","timestamp":1777379774000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/00031348221082276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,14]]},"references-count":12,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1177\/00031348221082276"],"URL":"https:\/\/doi.org\/10.1177\/00031348221082276","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,14]]}}}