Papillary Breast Lesions

Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉Papillary lesions of the breast are common.

👉These highly vascular lesions are intraductal and may transform into malignant variants.

👉In benign papillary lesions, a vascular stalk may be demonstrated on color Doppler scanning while multiple feeding vessels may be seen when imaging malignant papillary lesions.

👉When papillary lesions infarct, the vascular stalk will not be demonstrated.

👉The ability to reliably distinguish papilloma, in-situ papillary carcinoma, and invasive papillary carcinoma is not possible with ultrasound and is quite challenging even on core biopsy.

👉Open surgical biopsy may need to be performed to distinguish malignant from benign papillary lesions.

👉An “acorn” cyst is lined with papillary apocrine metaplasia which can form a mural nodule.

👉The nodule in an acorn cyst is less echogenic than papillomas or papillary carcinomas, is usually concave, following the contour of the cyst (thus the appearance of a cap on an acorn) instead of convex, and does not have a vascular stalk.

👉The mural nodule caused by papillary apocrine metaplasia also would not extend into the duct as the papillary lesion shown in the image does. 

👉Tubular adenomas and fibroadenomas have a similar sonographic appearance and are frequently round or oval, although tubular adenomas can be fusiform or spindle shaped.

👉Both lesions occur during reproductive years and would not commonly present as a new finding in a postmenopausal patient.

 👉Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y cirujano de mamá de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

  • Es experto en el manejo del cáncer de mama.

 👉Es miembro de la American Society of Breast Surgeons:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

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#Surgeon

#Cirujano

#SurgicalOncologist

#CirujanoOncologo

#BreastSurgeon

#CirujanodeMama

#CancerSurgeon

#CirujanodeCancer

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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