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Is surgical excision necessary for focal atypical ductal hyperplasia found at stereotactic vacuum-assisted breast biopsy?
Ann Surg Oncol. 2008 Nov; 15(11):3232-8.AS

Abstract

BACKGROUND

Our goal was to determine the upgrade rate for lesions described as focal atypical ductal hyperplasia (ADH) after 9- or 11-gauge stereotactic vacuum-assisted breast biopsy (VABB) to determine whether surgical excision is indicated in this setting.

METHODS

We retrospectively reviewed the results of 991 consecutive 9- or 11-gauge stereotactic core VABB procedures from February 2001 through June 2006 and identified lesions diagnosed as ADH. On the basis of the descriptions in pathology reports each lesion was placed in one of three categories: (1) focal ADH, (2) ADH suspicious for ductal carcinoma-in-situ, or (3) ADH not otherwise specified. The final diagnosis after surgical excisional biopsy was determined from medical records. The frequencies and upgrade rates to carcinoma were calculated and compared for all lesions and for each ADH category.

RESULTS

A total of 141 (14.2%) of 991 lesions yielded ADH at stereotactic core VABB, and 123 (87.2%) of 141 underwent surgical excisional biopsy of the stereotactic core VABB site. A total of 56 (45.5%) of 123 were categorized as focal ADH, and 7 (12.5%) of 56 were upgraded to carcinoma. A total of 49 (39.8%) of 123 were categorized as ADH not otherwise specified, and 11 (22.4%) of 49 were upgraded. Eighteen (14.6%) of 123 were categorized as suspicious for ductal carcinoma-in-situ, and 8 (44.4%) of 18 were upgraded. Neither the frequency of ADH (P = .66) nor the upgrade rates (P = .87) were significantly different between 9- and 11-gauge VABB.

CONCLUSION

Surgical excisional biopsy is indicated to exclude carcinoma in cases of focal ADH discovered at 9- or 11-gauge VABB.

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Authors+Show Affiliations

Eby PR
Department of Radiology, University of Washington Medical Center, 1959 NE Pacific, Seattle, WA 98195, USA. preby@u.washington.edu
Ochsner JE
No affiliation info available
DeMartini WB
No affiliation info available
Allison KH
No affiliation info available
Peacock S
No affiliation info available
Lehman CD
No affiliation info available

MeSH

AdultAgedBiopsy, NeedleBreast NeoplasmsCarcinoma, Intraductal, NoninfiltratingFemaleFollow-Up StudiesHumansHyperplasiaMammographyMiddle AgedNeoplasm InvasivenessRetrospective StudiesStereotaxic TechniquesVacuum

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18696163

Citation

Eby, Peter R., et al. "Is Surgical Excision Necessary for Focal Atypical Ductal Hyperplasia Found at Stereotactic Vacuum-assisted Breast Biopsy?" Annals of Surgical Oncology, vol. 15, no. 11, 2008, pp. 3232-8.
Eby PR, Ochsner JE, DeMartini WB, et al. Is surgical excision necessary for focal atypical ductal hyperplasia found at stereotactic vacuum-assisted breast biopsy? Ann Surg Oncol. 2008;15(11):3232-8.
Eby, P. R., Ochsner, J. E., DeMartini, W. B., Allison, K. H., Peacock, S., & Lehman, C. D. (2008). Is surgical excision necessary for focal atypical ductal hyperplasia found at stereotactic vacuum-assisted breast biopsy? Annals of Surgical Oncology, 15(11), 3232-8. https://doi.org/10.1245/s10434-008-0100-2
Eby PR, et al. Is Surgical Excision Necessary for Focal Atypical Ductal Hyperplasia Found at Stereotactic Vacuum-assisted Breast Biopsy. Ann Surg Oncol. 2008;15(11):3232-8. PubMed PMID: 18696163.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is surgical excision necessary for focal atypical ductal hyperplasia found at stereotactic vacuum-assisted breast biopsy? AU - Eby,Peter R, AU - Ochsner,Jennifer E, AU - DeMartini,Wendy B, AU - Allison,Kimberly H, AU - Peacock,Sue, AU - Lehman,Constance D, Y1 - 2008/08/12/ PY - 2008/06/20/received PY - 2008/07/10/accepted PY - 2008/07/09/revised PY - 2008/8/13/pubmed PY - 2009/1/30/medline PY - 2008/8/13/entrez SP - 3232 EP - 8 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 15 IS - 11 N2 - BACKGROUND: Our goal was to determine the upgrade rate for lesions described as focal atypical ductal hyperplasia (ADH) after 9- or 11-gauge stereotactic vacuum-assisted breast biopsy (VABB) to determine whether surgical excision is indicated in this setting. METHODS: We retrospectively reviewed the results of 991 consecutive 9- or 11-gauge stereotactic core VABB procedures from February 2001 through June 2006 and identified lesions diagnosed as ADH. On the basis of the descriptions in pathology reports each lesion was placed in one of three categories: (1) focal ADH, (2) ADH suspicious for ductal carcinoma-in-situ, or (3) ADH not otherwise specified. The final diagnosis after surgical excisional biopsy was determined from medical records. The frequencies and upgrade rates to carcinoma were calculated and compared for all lesions and for each ADH category. RESULTS: A total of 141 (14.2%) of 991 lesions yielded ADH at stereotactic core VABB, and 123 (87.2%) of 141 underwent surgical excisional biopsy of the stereotactic core VABB site. A total of 56 (45.5%) of 123 were categorized as focal ADH, and 7 (12.5%) of 56 were upgraded to carcinoma. A total of 49 (39.8%) of 123 were categorized as ADH not otherwise specified, and 11 (22.4%) of 49 were upgraded. Eighteen (14.6%) of 123 were categorized as suspicious for ductal carcinoma-in-situ, and 8 (44.4%) of 18 were upgraded. Neither the frequency of ADH (P = .66) nor the upgrade rates (P = .87) were significantly different between 9- and 11-gauge VABB. CONCLUSION: Surgical excisional biopsy is indicated to exclude carcinoma in cases of focal ADH discovered at 9- or 11-gauge VABB. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/18696163/Is_surgical_excision_necessary_for_focal_atypical_ductal_hyperplasia_found_at_stereotactic_vacuum_assisted_breast_biopsy L2 - https://dx.doi.org/10.1245/s10434-008-0100-2 DB - PRIME DP - Unbound Medicine ER -