Upgrade Rate of Exclusively MRI-Detected Papillomas in Asymptomatic Patients Undergoing Screening or Extent of Disease Examinations.

This article investigates the upgrade rate to malignancy of exclusively MRI-detected benign papillomas in asymptomatic high-risk patients, including those with a history of or concurrent breast cancer. In a retrospective study of 117 MRI-guided biopsies meeting inclusion criteria, a 4% overall upgrade rate to malignancy was found, with 3% upgrading to ductal carcinoma in situ (DCIS) and 1% to invasive cancer; among benign papillomas without atypia, the upgrade rate to DCIS was 4%, with no invasive malignancies identified. The presence of concurrent ipsilateral breast malignancy was the only statistically significant factor associated with upgrade when considering all papillomas, but not when evaluating benign papillomas alone. These findings suggest that surgical excision may be warranted for MRI-detected benign papillomas in this patient population, although no benign papillomas upgraded to invasive cancer in this study.