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Pathologic review of atypical hyperplasia identified by image-guided breast needle core biopsy. Correlation with excision specimen.
Arch Pathol Lab Med. 2003 Jan; 127(1):49-54.AP

Abstract

CONTEXT

Management of breast needle core biopsies diagnosed as atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ is controversial. Current recommendations involve excisional biopsy to rule out ductal carcinoma in situ and/or invasive carcinoma, which have been reported in more than 50% of cases in some series.

OBJECTIVE

To determine how frequently these diagnoses made on needle core biopsy are ultimately found to represent in situ or invasive carcinoma based on excisional biopsy specimens, in order to identify predictive factors.

DESIGN

One thousand eight hundred thirty-six image-guided needle core biopsies were performed between January 1, 1995 and May 1, 2001. Fifty-four (2.9%) patients diagnosed with atypical ductal hyperplasia (n = 36), atypical lobular hyperplasia (n = 12), atypical ductal hyperplasia + atypical lobular hyperplasia (n = 3), or lobular carcinoma in situ (n = 3) subsequently underwent breast excisions. Pathologic features were reviewed in each of the needle core biopsies using Page's criteria and were then correlated with excision specimens.

SETTING

University medical center.

RESULTS

Review of the needle core biopsy cases with either ductal carcinoma in situ or invasive carcinoma + ductal carcinoma in situ on final excision showed that nucleoli were evident in most of the needle core cases, with foci of nuclear pleomorphism and individual cell necrosis or apoptosis.

CONCLUSION

A more precise diagnosis can be made by using strict criteria for atypical ductal hyperplasia versus ductal carcinoma in situ on needle core biopsy. Cytologic atypia, even if in a small area, particularly when there is apoptosis/individual cell necrosis, correlates with the finding of a more serious lesion on excision.

Authors+Show Affiliations

Department of Pathology, University of Texas Health Science Center, San Antonio 78229, USA. yehi@uthscsa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12521366

Citation

Yeh, I-Tien, et al. "Pathologic Review of Atypical Hyperplasia Identified By Image-guided Breast Needle Core Biopsy. Correlation With Excision Specimen." Archives of Pathology & Laboratory Medicine, vol. 127, no. 1, 2003, pp. 49-54.
Yeh IT, Dimitrov D, Otto P, et al. Pathologic review of atypical hyperplasia identified by image-guided breast needle core biopsy. Correlation with excision specimen. Arch Pathol Lab Med. 2003;127(1):49-54.
Yeh, I. T., Dimitrov, D., Otto, P., Miller, A. R., Kahlenberg, M. S., & Cruz, A. (2003). Pathologic review of atypical hyperplasia identified by image-guided breast needle core biopsy. Correlation with excision specimen. Archives of Pathology & Laboratory Medicine, 127(1), 49-54.
Yeh IT, et al. Pathologic Review of Atypical Hyperplasia Identified By Image-guided Breast Needle Core Biopsy. Correlation With Excision Specimen. Arch Pathol Lab Med. 2003;127(1):49-54. PubMed PMID: 12521366.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathologic review of atypical hyperplasia identified by image-guided breast needle core biopsy. Correlation with excision specimen. AU - Yeh,I-Tien, AU - Dimitrov,Diana, AU - Otto,Pamela, AU - Miller,Alexander R, AU - Kahlenberg,Morton S, AU - Cruz,Anatolio, PY - 2003/1/11/pubmed PY - 2003/2/27/medline PY - 2003/1/11/entrez SP - 49 EP - 54 JF - Archives of pathology & laboratory medicine JO - Arch Pathol Lab Med VL - 127 IS - 1 N2 - CONTEXT: Management of breast needle core biopsies diagnosed as atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ is controversial. Current recommendations involve excisional biopsy to rule out ductal carcinoma in situ and/or invasive carcinoma, which have been reported in more than 50% of cases in some series. OBJECTIVE: To determine how frequently these diagnoses made on needle core biopsy are ultimately found to represent in situ or invasive carcinoma based on excisional biopsy specimens, in order to identify predictive factors. DESIGN: One thousand eight hundred thirty-six image-guided needle core biopsies were performed between January 1, 1995 and May 1, 2001. Fifty-four (2.9%) patients diagnosed with atypical ductal hyperplasia (n = 36), atypical lobular hyperplasia (n = 12), atypical ductal hyperplasia + atypical lobular hyperplasia (n = 3), or lobular carcinoma in situ (n = 3) subsequently underwent breast excisions. Pathologic features were reviewed in each of the needle core biopsies using Page's criteria and were then correlated with excision specimens. SETTING: University medical center. RESULTS: Review of the needle core biopsy cases with either ductal carcinoma in situ or invasive carcinoma + ductal carcinoma in situ on final excision showed that nucleoli were evident in most of the needle core cases, with foci of nuclear pleomorphism and individual cell necrosis or apoptosis. CONCLUSION: A more precise diagnosis can be made by using strict criteria for atypical ductal hyperplasia versus ductal carcinoma in situ on needle core biopsy. Cytologic atypia, even if in a small area, particularly when there is apoptosis/individual cell necrosis, correlates with the finding of a more serious lesion on excision. SN - 1543-2165 UR - https://www.unboundmedicine.com/medline/citation/12521366/Pathologic_review_of_atypical_hyperplasia_identified_by_image_guided_breast_needle_core_biopsy__Correlation_with_excision_specimen_ L2 - https://meridian.allenpress.com/aplm/article-lookup/doi/10.1043/0003-9985(2003)127<49:PROAHI>2.0.CO;2 DB - PRIME DP - Unbound Medicine ER -