Atypical Ductal Hyperplasia on Core Biopsy: An Automatic Trigger for Excisional Biopsy?

Introduction Excisional biopsy is currently recommended for atypical ductal hyperplasia (ADH) diagnosed on core needle breast biopsy (CNB), due to risk of upstaging to invasive or in situ carcinoma (DCIS). The study goal was to identify patients who may potentially forego excisional biopsy if the ri...

Full description

Saved in:
Bibliographic Details
Published in:Annals of surgical oncology 2012-10, Vol.19 (10), p.3264-3269
Main Authors: McGhan, Lee J., Pockaj, Barbara A., Wasif, Nabil, Giurescu, Marina E., McCullough, Ann E., Gray, Richard J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biopsy, Needle
Breast Neoplasms - diagnosis
Breast Neoplasms - surgery
Breast Oncology
Carcinoma, Ductal, Breast - diagnosis
Carcinoma, Ductal, Breast - surgery
Carcinoma, Intraductal, Noninfiltrating - diagnosis
Carcinoma, Intraductal, Noninfiltrating - surgery
Carcinoma, Lobular - diagnosis
Carcinoma, Lobular - surgery
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Hyperplasia - diagnosis
Hyperplasia - surgery
Mammography
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Oncology
Prognosis
Retrospective Studies
Surgery
Surgical Oncology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction Excisional biopsy is currently recommended for atypical ductal hyperplasia (ADH) diagnosed on core needle breast biopsy (CNB), due to risk of upstaging to invasive or in situ carcinoma (DCIS). The study goal was to identify patients who may potentially forego excisional biopsy if the risk of upstaging is low. Methods We conducted a retrospective review of patients diagnosed with ADH on CNB who underwent excisional biopsy at one institution (5/2000–5/2011). We evaluated the upstaging rate and clinicopathologic factors associated with increased upstaging risk. Results A total of 114 cases of ADH were diagnosed on CNB. The median patient age was 64 years. On mammography, a mass/density/area of distortion was present in 23 % of cases; calcifications were present in 77 %. Most biopsies (79 %) were performed stereotactically. Twenty lesions (18 %) were upstaged to infiltrating carcinoma (5 %) or DCIS (13 %). Residual ADH was present in 43 biopsies (38 %). On univariate analysis, significant variables associated with upstaging included age >50 years, a mass lesion on mammography, and shorter length of biopsy core ( p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-012-2575-0