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Atypical ductal hyperplasia diagnosis by directional vacuum-assisted stereotactic biopsy of breast microcalcifications. Considerations for surgical excision.
Am J Clin Pathol. 2003 Feb; 119(2):248-53.AJ

Abstract

In 824 patients who underwent directional vacuum-assisted biopsies (DVABs) of breast microcalcifications, 61 (7.4%) showed atypical ductal hyperplasia (ADH). The 42 who subsequently underwent excision were the subjects of this study. Cases were evaluated for the mammographic characteristics of the lesion, the percentage of lesion removed according to mammography, and histologic findings (including number of large ducts and/or terminal duct-lobular units involved with ADH) in DVAB specimens. Pathologic findings in the surgical specimens in the area of the biopsy site also were recorded. In the DVAB specimens, ADH was confined to an average of 1.5 large ducts or lobular units and was associated with microcalcifications in all of the patients. Surgical specimens showed ADH in 15 cases, no residual lesion in 24 cases, and ductal carcinoma in situ in 3 cases. We found that microcalcifications that contain ADH in less than 3 lobules or ducts and/or that are removed completely by DVAB do not reveal higher-risk lesions on excision; thus, removal is unnecessary. When assessing microcalcifications with ADH, clinicians should consider the percentage of microcalcifications removed by DVAB and the extent of lobular involvement to better assess the need for excision.

Authors+Show Affiliations

Sneige N
Department of Pathology, University of Texas M.D. Anderson Cancer Center, Unit 53, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Lim SC
No affiliation info available
Whitman GJ
No affiliation info available
Krishnamurthy S
No affiliation info available
Sahin AA
No affiliation info available
Smith TL
No affiliation info available
Stelling CB
No affiliation info available

MeSH

AdultAgedBiopsy, NeedleBreast NeoplasmsCalcinosisCarcinoma, Ductal, BreastFemaleHumansHyperplasiaMammographyMiddle AgedPrecancerous ConditionsRetrospective StudiesStereotaxic TechniquesVacuum

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12579995

Citation

Sneige, Nour, et al. "Atypical Ductal Hyperplasia Diagnosis By Directional Vacuum-assisted Stereotactic Biopsy of Breast Microcalcifications. Considerations for Surgical Excision." American Journal of Clinical Pathology, vol. 119, no. 2, 2003, pp. 248-53.
Sneige N, Lim SC, Whitman GJ, et al. Atypical ductal hyperplasia diagnosis by directional vacuum-assisted stereotactic biopsy of breast microcalcifications. Considerations for surgical excision. Am J Clin Pathol. 2003;119(2):248-53.
Sneige, N., Lim, S. C., Whitman, G. J., Krishnamurthy, S., Sahin, A. A., Smith, T. L., & Stelling, C. B. (2003). Atypical ductal hyperplasia diagnosis by directional vacuum-assisted stereotactic biopsy of breast microcalcifications. Considerations for surgical excision. American Journal of Clinical Pathology, 119(2), 248-53.
Sneige N, et al. Atypical Ductal Hyperplasia Diagnosis By Directional Vacuum-assisted Stereotactic Biopsy of Breast Microcalcifications. Considerations for Surgical Excision. Am J Clin Pathol. 2003;119(2):248-53. PubMed PMID: 12579995.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atypical ductal hyperplasia diagnosis by directional vacuum-assisted stereotactic biopsy of breast microcalcifications. Considerations for surgical excision. AU - Sneige,Nour, AU - Lim,Sung C, AU - Whitman,Gary J, AU - Krishnamurthy,Savitri, AU - Sahin,Aysegul A, AU - Smith,Terry L, AU - Stelling,Carol B, PY - 2003/2/13/pubmed PY - 2003/2/27/medline PY - 2003/2/13/entrez SP - 248 EP - 53 JF - American journal of clinical pathology JO - Am J Clin Pathol VL - 119 IS - 2 N2 - In 824 patients who underwent directional vacuum-assisted biopsies (DVABs) of breast microcalcifications, 61 (7.4%) showed atypical ductal hyperplasia (ADH). The 42 who subsequently underwent excision were the subjects of this study. Cases were evaluated for the mammographic characteristics of the lesion, the percentage of lesion removed according to mammography, and histologic findings (including number of large ducts and/or terminal duct-lobular units involved with ADH) in DVAB specimens. Pathologic findings in the surgical specimens in the area of the biopsy site also were recorded. In the DVAB specimens, ADH was confined to an average of 1.5 large ducts or lobular units and was associated with microcalcifications in all of the patients. Surgical specimens showed ADH in 15 cases, no residual lesion in 24 cases, and ductal carcinoma in situ in 3 cases. We found that microcalcifications that contain ADH in less than 3 lobules or ducts and/or that are removed completely by DVAB do not reveal higher-risk lesions on excision; thus, removal is unnecessary. When assessing microcalcifications with ADH, clinicians should consider the percentage of microcalcifications removed by DVAB and the extent of lobular involvement to better assess the need for excision. SN - 0002-9173 UR - https://www.unboundmedicine.com/medline/citation/12579995/Atypical_ductal_hyperplasia_diagnosis_by_directional_vacuum_assisted_stereotactic_biopsy_of_breast_microcalcifications__Considerations_for_surgical_excision_ DB - PRIME DP - Unbound Medicine ER -