Tags

Type your tag names separated by a space and hit enter

Risk of upgrade of atypical ductal hyperplasia after stereotactic breast biopsy: effects of number of foci and complete removal of calcifications.
Radiology. 2010 Jun; 255(3):723-30.R

Abstract

PURPOSE

To determine if patients with fewer than three foci of atypical ductal hyperplasia (ADH) who have all of their calcifications removed after stereotactic 9- or 11-gauge vacuum-assisted breast biopsy (VABB) have a rate of upgrade to malignancy that is sufficiently low to obviate surgical excision.

MATERIALS AND METHODS

An institutional review board-approved, HIPAA-compliant retrospective review of 991 cases of consecutive 9- or 11-gauge stereotactic VABB performed during a 65-month period revealed 147 cases of atypia. One pathologist performed a blinded review of the results of procedures performed to assess for calcifications and confirmed ADH in 101 cases with subsequent surgical excision. Each large duct or terminal duct-lobular unit containing ADH was considered a focus and counted. Postbiopsy mammograms were reviewed to determine whether all calcifications were removed. Upgrade to malignancy was determined from excisional biopsy pathology reports. Upgrade rates as a function of both number of foci and presence or absence of residual calcifications were calculated and compared by using chi(2) tests.

RESULTS

Upgrade to malignancy occurred in 20 (19.8%) of the 101 cases. The upgrade rate was significantly higher in cases of three or more foci of ADH (15 [28%] of 53 cases) than in cases of fewer than three foci (five [10%] of 48 cases) (P = .02). Upgrade rates were similar, regardless of whether all mammographic calcifications were removed (seven [17%] of 41 cases) or all were not removed (nine [20%] of 45 cases) (P = .77). Upgrade occurred in two (12%) of 17 cases in which there were fewer than three ADH foci and all calcifications were removed.

CONCLUSION

The upgrade rate is significantly higher when ADH involves at least three foci. Surgical excision is recommended even when ADH involves fewer than three foci and all mammographic calcifications have been removed, because the upgrade rate is 12%.

Authors+Show Affiliations

Department of Radiology, University of Washington Medical Center, Seattle, Wash., USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

20173103

Citation

Kohr, Jennifer R., et al. "Risk of Upgrade of Atypical Ductal Hyperplasia After Stereotactic Breast Biopsy: Effects of Number of Foci and Complete Removal of Calcifications." Radiology, vol. 255, no. 3, 2010, pp. 723-30.
Kohr JR, Eby PR, Allison KH, et al. Risk of upgrade of atypical ductal hyperplasia after stereotactic breast biopsy: effects of number of foci and complete removal of calcifications. Radiology. 2010;255(3):723-30.
Kohr, J. R., Eby, P. R., Allison, K. H., DeMartini, W. B., Gutierrez, R. L., Peacock, S., & Lehman, C. D. (2010). Risk of upgrade of atypical ductal hyperplasia after stereotactic breast biopsy: effects of number of foci and complete removal of calcifications. Radiology, 255(3), 723-30. https://doi.org/10.1148/radiol.09091406
Kohr JR, et al. Risk of Upgrade of Atypical Ductal Hyperplasia After Stereotactic Breast Biopsy: Effects of Number of Foci and Complete Removal of Calcifications. Radiology. 2010;255(3):723-30. PubMed PMID: 20173103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of upgrade of atypical ductal hyperplasia after stereotactic breast biopsy: effects of number of foci and complete removal of calcifications. AU - Kohr,Jennifer R, AU - Eby,Peter R, AU - Allison,Kimberly H, AU - DeMartini,Wendy B, AU - Gutierrez,Robert L, AU - Peacock,Sue, AU - Lehman,Constance D, Y1 - 2010/02/19/ PY - 2010/2/23/entrez PY - 2010/2/23/pubmed PY - 2010/7/16/medline SP - 723 EP - 30 JF - Radiology JO - Radiology VL - 255 IS - 3 N2 - PURPOSE: To determine if patients with fewer than three foci of atypical ductal hyperplasia (ADH) who have all of their calcifications removed after stereotactic 9- or 11-gauge vacuum-assisted breast biopsy (VABB) have a rate of upgrade to malignancy that is sufficiently low to obviate surgical excision. MATERIALS AND METHODS: An institutional review board-approved, HIPAA-compliant retrospective review of 991 cases of consecutive 9- or 11-gauge stereotactic VABB performed during a 65-month period revealed 147 cases of atypia. One pathologist performed a blinded review of the results of procedures performed to assess for calcifications and confirmed ADH in 101 cases with subsequent surgical excision. Each large duct or terminal duct-lobular unit containing ADH was considered a focus and counted. Postbiopsy mammograms were reviewed to determine whether all calcifications were removed. Upgrade to malignancy was determined from excisional biopsy pathology reports. Upgrade rates as a function of both number of foci and presence or absence of residual calcifications were calculated and compared by using chi(2) tests. RESULTS: Upgrade to malignancy occurred in 20 (19.8%) of the 101 cases. The upgrade rate was significantly higher in cases of three or more foci of ADH (15 [28%] of 53 cases) than in cases of fewer than three foci (five [10%] of 48 cases) (P = .02). Upgrade rates were similar, regardless of whether all mammographic calcifications were removed (seven [17%] of 41 cases) or all were not removed (nine [20%] of 45 cases) (P = .77). Upgrade occurred in two (12%) of 17 cases in which there were fewer than three ADH foci and all calcifications were removed. CONCLUSION: The upgrade rate is significantly higher when ADH involves at least three foci. Surgical excision is recommended even when ADH involves fewer than three foci and all mammographic calcifications have been removed, because the upgrade rate is 12%. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/20173103/Risk_of_upgrade_of_atypical_ductal_hyperplasia_after_stereotactic_breast_biopsy:_effects_of_number_of_foci_and_complete_removal_of_calcifications_ L2 - https://pubs.rsna.org/doi/10.1148/radiol.09091406?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -