Antuono Latronico1, Luca Nicosia2, Angela Faggian3, Francesca Abbate1, Silvia Penco1, Anna Bozzini1, Christine Cannataci4, Giovanni Mazzarol5, Enrico Cassano1. 1. European Institute of Oncology, Breast Imaging Unit, Via G. Ripamonti, 435, 20141, Milano, Italy. 2. Postgraduate School of Radiology, Università degli Studi di Milano, Milan, Via Festa del Perdono 7, Milan, Italy. Electronic address: lucanicosia88@gmail.com. 3. Department of Radiology, Private Hospital "Villa dei Fiori", Acerra, Naples, Italy. 4. Medical Imaging Department, Mater Dei Hospital, Triq Dun Karm, Msida, MSD 2090, Malta. 5. European Institute of Oncology, Pathology Department, Via G. Ripamonti, 435, 20141, Milano, Italy.
Abstract
INTRODUCTION: Atypical ductal hyperplasia (ADH) is a high-risk benign lesion found in approximately 1-10% of breast biopsies and associated with a variable incidence of carcinoma after surgical excision. The main goal of our study is to present our experience in the management and long-term follow-up of 71 patients with ADH diagnosed on breast biopsy. MATERIALS AND METHODS: Results of 3808 breast biopsy specimens from 1 January 2000 to 31 December 2005 were analyzed to identify all biopsies which resulted in a diagnosis of ADH. The histopathological results of the 45 patients who underwent surgery were analyzed. Long-term follow-up for the remaining patients was carried out. RESULTS: 45 of 71 (63.4%) patients with histological diagnosis of ADH on breast biopsy underwent surgery. Definitive histological results revealed invasive carcinoma in 7 cases (15.6%), high grade Ductal Carcinoma in situ (DCIS) in 10 (22.2%) patients, Lobular Carcinoma in situ (LCIS) in 4 cases (8.9%) and benign findings in 24 cases (53.3%). 12 of 71 (16.9%) patients underwent only long term follow-up; one (8,3%) of these developed invasive breast carcinoma after 6 years. CONCLUSION: Atypical ductal hyperplasia diagnosed on breast biopsy is associated with a relatively high incidence of invasive carcinoma and high grade ductal carcinoma in situ at the time of surgical excision. Certain radiological and cytological criteria can be used to help determine which patients should forgo surgery and be followed up with good results. Long term follow-up is always crucial for patients who have not undergone surgery.
INTRODUCTION:Atypical ductal hyperplasia (ADH) is a high-risk benign lesion found in approximately 1-10% of breast biopsies and associated with a variable incidence of carcinoma after surgical excision. The main goal of our study is to present our experience in the management and long-term follow-up of 71 patients with ADH diagnosed on breast biopsy. MATERIALS AND METHODS: Results of 3808 breast biopsy specimens from 1 January 2000 to 31 December 2005 were analyzed to identify all biopsies which resulted in a diagnosis of ADH. The histopathological results of the 45 patients who underwent surgery were analyzed. Long-term follow-up for the remaining patients was carried out. RESULTS: 45 of 71 (63.4%) patients with histological diagnosis of ADH on breast biopsy underwent surgery. Definitive histological results revealed invasive carcinoma in 7 cases (15.6%), high grade Ductal Carcinoma in situ (DCIS) in 10 (22.2%) patients, Lobular Carcinoma in situ (LCIS) in 4 cases (8.9%) and benign findings in 24 cases (53.3%). 12 of 71 (16.9%) patients underwent only long term follow-up; one (8,3%) of these developed invasive breast carcinoma after 6 years. CONCLUSION:Atypical ductal hyperplasia diagnosed on breast biopsy is associated with a relatively high incidence of invasive carcinoma and high grade ductal carcinoma in situ at the time of surgical excision. Certain radiological and cytological criteria can be used to help determine which patients should forgo surgery and be followed up with good results. Long term follow-up is always crucial for patients who have not undergone surgery.
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
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