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Upstaging of atypical ductal hyperplasia after vacuum-assisted 11-gauge stereotactic core needle biopsy.
Arch Surg. 2003 Jun; 138(6):619-22; discussion 622-3.AS

Abstract

BACKGROUND

Nonpalpable mammographic abnormalities are frequently evaluated by means of a stereotactic core needle biopsy. This technique is a very sensitive indicator of invasive cancer, but is less reliable to discriminate between ductal carcinoma in situ and atypical ductal hyperplasia (ADH). The objective of this study was to determine the correlation of the 11-gauge vacuum-assisted core needle biopsy to open biopsy when a diagnosis of ADH is obtained.

HYPOTHESIS

The use of 11-gauge vacuum-assisted stereotactic core needle biopsy does not conclusively diagnose ADH.

DESIGN

Retrospective analysis.

SETTING

University-affiliated teaching hospital.

PATIENTS

Mammographic findings were evaluated with an 11-gauge vacuum-assisted stereotactic core biopsy in 1750 patients. Seventy-seven patients were diagnosed as having ADH; of these, 65 underwent excisional biopsy.

MAIN OUTCOME MEASURES

Pathological upstaging rate.

RESULTS

Of the 65 patients who underwent excisional breast biopsy, 11 (17%) had their condition upstaged to a breast cancer diagnosis. These patients had presented at a later age than those who retained a benign diagnosis after excisional biopsy. The number of cores taken did not correlate with diagnostic accuracy.

CONCLUSIONS

Of the 65 patients who underwent open biopsy for ADH in this series, only 83% had an accurate diagnosis. A diagnosis of ADH by stereotactic core needle biopsy should be followed by an open excisional biopsy.

Authors+Show Affiliations

Winchester DJ
Department of Surgery, Evanston Northwestern Healthcare, Evanston, Ill 60201, USA. djwinch@northwestern.edu
Bernstein JR
No affiliation info available
Jeske JM
No affiliation info available
Nicholson MH
No affiliation info available
Hahn EA
No affiliation info available
Goldschmidt RA
No affiliation info available
Watkin WG
No affiliation info available
Sener SF
No affiliation info available
Bilimoria MB
No affiliation info available
Barrera E
No affiliation info available
Winchester DP
No affiliation info available

MeSH

AdultAgedAged, 80 and overBiopsyBiopsy, NeedleBreastBreast NeoplasmsCarcinoma, Intraductal, NoninfiltratingFemaleHumansHyperplasiaMammographyMiddle AgedNeoplasm StagingPrecancerous ConditionsRetrospective StudiesSurgery, Computer-Assisted

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12799332

Citation

Winchester, David J., et al. "Upstaging of Atypical Ductal Hyperplasia After Vacuum-assisted 11-gauge Stereotactic Core Needle Biopsy." Archives of Surgery (Chicago, Ill. : 1960), vol. 138, no. 6, 2003, pp. 619-22; discussion 622-3.
Winchester DJ, Bernstein JR, Jeske JM, et al. Upstaging of atypical ductal hyperplasia after vacuum-assisted 11-gauge stereotactic core needle biopsy. Arch Surg. 2003;138(6):619-22; discussion 622-3.
Winchester, D. J., Bernstein, J. R., Jeske, J. M., Nicholson, M. H., Hahn, E. A., Goldschmidt, R. A., Watkin, W. G., Sener, S. F., Bilimoria, M. B., Barrera, E., & Winchester, D. P. (2003). Upstaging of atypical ductal hyperplasia after vacuum-assisted 11-gauge stereotactic core needle biopsy. Archives of Surgery (Chicago, Ill. : 1960), 138(6), 619-22; discussion 622-3.
Winchester DJ, et al. Upstaging of Atypical Ductal Hyperplasia After Vacuum-assisted 11-gauge Stereotactic Core Needle Biopsy. Arch Surg. 2003;138(6):619-22; discussion 622-3. PubMed PMID: 12799332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Upstaging of atypical ductal hyperplasia after vacuum-assisted 11-gauge stereotactic core needle biopsy. AU - Winchester,David J, AU - Bernstein,Joel R, AU - Jeske,Jan M, AU - Nicholson,Mary H, AU - Hahn,Elizabeth A, AU - Goldschmidt,Robert A, AU - Watkin,William G, AU - Sener,Stephen F, AU - Bilimoria,Malcolm B, AU - Barrera,Ermilio,Jr AU - Winchester,David P, PY - 2003/6/12/pubmed PY - 2003/7/9/medline PY - 2003/6/12/entrez SP - 619-22; discussion 622-3 JF - Archives of surgery (Chicago, Ill. : 1960) JO - Arch Surg VL - 138 IS - 6 N2 - BACKGROUND: Nonpalpable mammographic abnormalities are frequently evaluated by means of a stereotactic core needle biopsy. This technique is a very sensitive indicator of invasive cancer, but is less reliable to discriminate between ductal carcinoma in situ and atypical ductal hyperplasia (ADH). The objective of this study was to determine the correlation of the 11-gauge vacuum-assisted core needle biopsy to open biopsy when a diagnosis of ADH is obtained. HYPOTHESIS: The use of 11-gauge vacuum-assisted stereotactic core needle biopsy does not conclusively diagnose ADH. DESIGN: Retrospective analysis. SETTING: University-affiliated teaching hospital. PATIENTS: Mammographic findings were evaluated with an 11-gauge vacuum-assisted stereotactic core biopsy in 1750 patients. Seventy-seven patients were diagnosed as having ADH; of these, 65 underwent excisional biopsy. MAIN OUTCOME MEASURES: Pathological upstaging rate. RESULTS: Of the 65 patients who underwent excisional breast biopsy, 11 (17%) had their condition upstaged to a breast cancer diagnosis. These patients had presented at a later age than those who retained a benign diagnosis after excisional biopsy. The number of cores taken did not correlate with diagnostic accuracy. CONCLUSIONS: Of the 65 patients who underwent open biopsy for ADH in this series, only 83% had an accurate diagnosis. A diagnosis of ADH by stereotactic core needle biopsy should be followed by an open excisional biopsy. SN - 0004-0010 UR - https://www.unboundmedicine.com/medline/citation/12799332/Upstaging_of_atypical_ductal_hyperplasia_after_vacuum_assisted_11_gauge_stereotactic_core_needle_biopsy_ DB - PRIME DP - Unbound Medicine ER -