BACKGROUND: Atypical ductal hyperplasia (ADH) is diagnosed in 4% to 10% of directional vacuum-assisted stereotactic biopsies (DVABs) performed for microcalcifications. Since the underestimation rate varies from 7% to 36%, surgical excision is still recommended, although some authors have tried to identify a subset of patients who can be spared surgery. METHODS AND RESULTS: In this study, we analyzed a retrospective series of 300 patients with ADH on 11-gauge DVAB. The only 4 events that occurred (3%) in 135 of 184 patients (61%) who were followed may not be due to underestimation. Comparing the diagnoses on DVAB and surgical excisions for 116 patients (39%), we identified 3 subsets of patients: no underestimation (size <6 mm and complete removal), low rate of 4% (< or =2 foci ADH in microcalcifications either <6 mm with incomplete removal or > or =6 mm and <21 mm), and high rate of 36% to 38% (>2 foci ADH in microcalcifications either <6 mm with incomplete removal or > or =6 mm and <21 mm, lesion size > or =21 mm). CONCLUSIONS: Our results suggest that strict follow-up can be a safe option for the first 2 groups of patients, but that surgical excision is mandatory for patients from the third group.
BACKGROUND:Atypical ductal hyperplasia (ADH) is diagnosed in 4% to 10% of directional vacuum-assisted stereotactic biopsies (DVABs) performed for microcalcifications. Since the underestimation rate varies from 7% to 36%, surgical excision is still recommended, although some authors have tried to identify a subset of patients who can be spared surgery. METHODS AND RESULTS: In this study, we analyzed a retrospective series of 300 patients with ADH on 11-gauge DVAB. The only 4 events that occurred (3%) in 135 of 184 patients (61%) who were followed may not be due to underestimation. Comparing the diagnoses on DVAB and surgical excisions for 116 patients (39%), we identified 3 subsets of patients: no underestimation (size <6 mm and complete removal), low rate of 4% (< or =2 foci ADH in microcalcifications either <6 mm with incomplete removal or > or =6 mm and <21 mm), and high rate of 36% to 38% (>2 foci ADH in microcalcifications either <6 mm with incomplete removal or > or =6 mm and <21 mm, lesion size > or =21 mm). CONCLUSIONS: Our results suggest that strict follow-up can be a safe option for the first 2 groups of patients, but that surgical excision is mandatory for patients from the third group.
Authors: Marco Lucioni; Chiara Rossi; Pascal Lomoro; Francesco Ballati; Marianna Fanizza; Alberta Ferrari; Carlos A Garcia-Etienne; Emanuela Boveri; Giulia Meloni; Maria Grazia Sommaruga; Elisa Ferraris; Angioletta Lasagna; Elisabetta Bonzano; Marco Paulli; Adele Sgarella; Giuseppe Di Giulio Journal: Eur Radiol Date: 2020-08-20 Impact factor: 5.315
Authors: Christoph J Rageth; Elizabeth Am O'Flynn; Christopher Comstock; Claudia Kurtz; Rahel Kubik; Helmut Madjar; Domenico Lepori; Gert Kampmann; Alexander Mundinger; Astrid Baege; Thomas Decker; Stefanie Hosch; Christoph Tausch; Jean-François Delaloye; Elisabeth Morris; Zsuzsanna Varga Journal: Breast Cancer Res Treat Date: 2016-08-13 Impact factor: 4.872