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Extent and histologic pattern of atypical ductal hyperplasia present on core needle biopsy specimens of the breast can predict ductal carcinoma in situ in subsequent excision.
Am J Clin Pathol. 2009 Jan; 131(1):112-21.AJ

Abstract

Atypical ductal hyperplasia (ADH) diagnosed by core needle biopsy (CNB) is regarded as an indication for surgical excision. We investigated whether histologic subtype and extent of ADH in a series of 123 CNB specimens can predict the presence of carcinoma on surgical excision. We found that ADH present in more than 2 foci in CNB specimens was a strong predictor of ductal carcinoma in situ (DCIS) on excision (>2 foci, 16/41 vs 6/82 for 1 or 2 foci; P < .0001). The micropapillary subtype of ADH also predicted the presence of DCIS (P = .0006). Our study suggests that micropapillary histologic subtype and extent of ADH in CNB specimens can be applied to predict the presence of DCIS on surgical excision. By using the combination of the extent of ADH in CNB specimens (1 or 2 foci), the presence of microcalcifications within the lesion, and the lack of residual mammographic calcifications after CNB, we identified a low-risk group of patients (n = 25), none of whom had carcinoma on surgical excision. Patients with ADH restricted to fewer than 3 foci may not need surgical excision, especially when the mammographic abnormality is completely removed by CNB.

Authors+Show Affiliations

Department of Pathology and Cell Biology, University of South Florida College of Medicine, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19095574

Citation

Wagoner, Michael J., et al. "Extent and Histologic Pattern of Atypical Ductal Hyperplasia Present On Core Needle Biopsy Specimens of the Breast Can Predict Ductal Carcinoma in Situ in Subsequent Excision." American Journal of Clinical Pathology, vol. 131, no. 1, 2009, pp. 112-21.
Wagoner MJ, Laronga C, Acs G. Extent and histologic pattern of atypical ductal hyperplasia present on core needle biopsy specimens of the breast can predict ductal carcinoma in situ in subsequent excision. Am J Clin Pathol. 2009;131(1):112-21.
Wagoner, M. J., Laronga, C., & Acs, G. (2009). Extent and histologic pattern of atypical ductal hyperplasia present on core needle biopsy specimens of the breast can predict ductal carcinoma in situ in subsequent excision. American Journal of Clinical Pathology, 131(1), 112-21. https://doi.org/10.1309/AJCPGHEJ2R8UYFGP
Wagoner MJ, Laronga C, Acs G. Extent and Histologic Pattern of Atypical Ductal Hyperplasia Present On Core Needle Biopsy Specimens of the Breast Can Predict Ductal Carcinoma in Situ in Subsequent Excision. Am J Clin Pathol. 2009;131(1):112-21. PubMed PMID: 19095574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extent and histologic pattern of atypical ductal hyperplasia present on core needle biopsy specimens of the breast can predict ductal carcinoma in situ in subsequent excision. AU - Wagoner,Michael J, AU - Laronga,Christine, AU - Acs,Geza, PY - 2008/12/20/entrez PY - 2008/12/20/pubmed PY - 2009/1/23/medline SP - 112 EP - 21 JF - American journal of clinical pathology JO - Am J Clin Pathol VL - 131 IS - 1 N2 - Atypical ductal hyperplasia (ADH) diagnosed by core needle biopsy (CNB) is regarded as an indication for surgical excision. We investigated whether histologic subtype and extent of ADH in a series of 123 CNB specimens can predict the presence of carcinoma on surgical excision. We found that ADH present in more than 2 foci in CNB specimens was a strong predictor of ductal carcinoma in situ (DCIS) on excision (>2 foci, 16/41 vs 6/82 for 1 or 2 foci; P < .0001). The micropapillary subtype of ADH also predicted the presence of DCIS (P = .0006). Our study suggests that micropapillary histologic subtype and extent of ADH in CNB specimens can be applied to predict the presence of DCIS on surgical excision. By using the combination of the extent of ADH in CNB specimens (1 or 2 foci), the presence of microcalcifications within the lesion, and the lack of residual mammographic calcifications after CNB, we identified a low-risk group of patients (n = 25), none of whom had carcinoma on surgical excision. Patients with ADH restricted to fewer than 3 foci may not need surgical excision, especially when the mammographic abnormality is completely removed by CNB. SN - 1943-7722 UR - https://www.unboundmedicine.com/medline/citation/19095574/Extent_and_histologic_pattern_of_atypical_ductal_hyperplasia_present_on_core_needle_biopsy_specimens_of_the_breast_can_predict_ductal_carcinoma_in_situ_in_subsequent_excision_ L2 - https://academic.oup.com/ajcp/article-lookup/doi/10.1309/AJCPGHEJ2R8UYFGP DB - PRIME DP - Unbound Medicine ER -