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Underestimation of atypical ductal hyperplasia at MRI-guided 9-gauge vacuum-assisted breast biopsy.
AJR Am J Roentgenol. 2007 Mar; 188(3):684-90.AA

Abstract

OBJECTIVE

The purposes of this study were to determine the frequency of diagnosis of atypical ductal hyperplasia (ADH) at MRI-guided 9-gauge vacuum-assisted breast biopsy and to assess the rate of underestimation of ADH at subsequent surgical excision.

MATERIALS AND METHODS

We conducted a retrospective review of medical records of 237 lesions consecutively detected with MRI and then subjected to MRI-guided 9-gauge vacuum-assisted breast biopsy during a 33-month period. Underestimated ADH was defined as a lesion yielding ADH at vacuum-assisted biopsy and cancer at surgery. Scientific tables were used to calculate 95% CI.

RESULTS

Histologic analysis of MRI-guided vacuum-assisted breast biopsy specimens yielded ADH without cancer in 15 (6%) of 237 lesions. Among 15 patients in whom vacuum-assisted breast biopsy yielded ADH, the median age was 52 years (range, 46-68 years). The median number of specimens obtained was nine (range, 8-18 lesions). Median MRI lesion diameter was 1.3 cm (range, 0.7-7.0 cm). Among 15 MRI lesions, 10 (67%) were nonmasslike enhancement and five (33%) were masses. Surgical excision was performed on 13 lesions. Surgical histologic findings were malignancy in five (38%) of the cases, all ductal carcinoma in situ; high-risk lesion in six (46%) of the cases, including ADH without other high-risk lesions (n = 2), ADH and lobular carcinoma in situ (LCIS) (n = 1), ADH, LCIS, and papilloma (n =1), ADH and papilloma (n = 1), and LCIS (n = 1); and benign in two (15%) of the cases. These data indicated an ADH underestimation rate of 38% (95% CI, 14-68%).

CONCLUSION

ADH without cancer was encountered in 6% of MRI-guided 9-gauge vacuum-assisted breast biopsies. ADH at MRI-guided vacuum-assisted breast biopsy is an indication for surgical excision because of the high (38%) frequency of underestimation of these lesions.

Authors+Show Affiliations

Breast Imaging Section, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021, USA. libermal@mskcc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17312054

Citation

Liberman, Laura, et al. "Underestimation of Atypical Ductal Hyperplasia at MRI-guided 9-gauge Vacuum-assisted Breast Biopsy." AJR. American Journal of Roentgenology, vol. 188, no. 3, 2007, pp. 684-90.
Liberman L, Holland AE, Marjan D, et al. Underestimation of atypical ductal hyperplasia at MRI-guided 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 2007;188(3):684-90.
Liberman, L., Holland, A. E., Marjan, D., Murray, M. P., Bartella, L., Morris, E. A., Dershaw, D. D., & Wynn, R. T. (2007). Underestimation of atypical ductal hyperplasia at MRI-guided 9-gauge vacuum-assisted breast biopsy. AJR. American Journal of Roentgenology, 188(3), 684-90.
Liberman L, et al. Underestimation of Atypical Ductal Hyperplasia at MRI-guided 9-gauge Vacuum-assisted Breast Biopsy. AJR Am J Roentgenol. 2007;188(3):684-90. PubMed PMID: 17312054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Underestimation of atypical ductal hyperplasia at MRI-guided 9-gauge vacuum-assisted breast biopsy. AU - Liberman,Laura, AU - Holland,Agnes E, AU - Marjan,Domagoj, AU - Murray,Melissa P, AU - Bartella,Lia, AU - Morris,Elizabeth A, AU - Dershaw,D David, AU - Wynn,Ralph T, PY - 2007/2/22/pubmed PY - 2007/4/20/medline PY - 2007/2/22/entrez SP - 684 EP - 90 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 188 IS - 3 N2 - OBJECTIVE: The purposes of this study were to determine the frequency of diagnosis of atypical ductal hyperplasia (ADH) at MRI-guided 9-gauge vacuum-assisted breast biopsy and to assess the rate of underestimation of ADH at subsequent surgical excision. MATERIALS AND METHODS: We conducted a retrospective review of medical records of 237 lesions consecutively detected with MRI and then subjected to MRI-guided 9-gauge vacuum-assisted breast biopsy during a 33-month period. Underestimated ADH was defined as a lesion yielding ADH at vacuum-assisted biopsy and cancer at surgery. Scientific tables were used to calculate 95% CI. RESULTS: Histologic analysis of MRI-guided vacuum-assisted breast biopsy specimens yielded ADH without cancer in 15 (6%) of 237 lesions. Among 15 patients in whom vacuum-assisted breast biopsy yielded ADH, the median age was 52 years (range, 46-68 years). The median number of specimens obtained was nine (range, 8-18 lesions). Median MRI lesion diameter was 1.3 cm (range, 0.7-7.0 cm). Among 15 MRI lesions, 10 (67%) were nonmasslike enhancement and five (33%) were masses. Surgical excision was performed on 13 lesions. Surgical histologic findings were malignancy in five (38%) of the cases, all ductal carcinoma in situ; high-risk lesion in six (46%) of the cases, including ADH without other high-risk lesions (n = 2), ADH and lobular carcinoma in situ (LCIS) (n = 1), ADH, LCIS, and papilloma (n =1), ADH and papilloma (n = 1), and LCIS (n = 1); and benign in two (15%) of the cases. These data indicated an ADH underestimation rate of 38% (95% CI, 14-68%). CONCLUSION: ADH without cancer was encountered in 6% of MRI-guided 9-gauge vacuum-assisted breast biopsies. ADH at MRI-guided vacuum-assisted breast biopsy is an indication for surgical excision because of the high (38%) frequency of underestimation of these lesions. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/17312054/Underestimation_of_atypical_ductal_hyperplasia_at_MRI_guided_9_gauge_vacuum_assisted_breast_biopsy_ L2 - https://www.ajronline.org/doi/10.2214/AJR.06.0809 DB - PRIME DP - Unbound Medicine ER -