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Atypical ductal hyperplasia diagnosed at 11-gauge vacuum-assisted breast biopsy performed on suspicious clustered microcalcifications: could patients without residual microcalcifications be managed conservatively?
AJR Am J Roentgenol. 2011 Oct; 197(4):1012-8.AA

Abstract

OBJECTIVE

The purpose of our study was to establish whether it might be safe for women with a diagnosis of atypical ductal hyperplasia (ADH) at stereotactically guided vacuum-assisted breast biopsy without any residual microcalcification after the procedure to undergo mammographic follow-up instead of surgical biopsy.

MATERIALS AND METHODS

From October 2003 to January 2009, 1173 consecutive 11-gauge vacuum-assisted breast biopsy procedures were performed. ADH was found in the specimens of 114 patients who underwent vacuum-assisted breast biopsy for a single cluster of suspicious microcalcifications smaller than 15 mm; 49 had residual microcalcifications, and 65 had microcalcifications completely removed by the procedure. Of 49 patients with residual microcalcifications, 41 underwent surgical biopsy. Of 65 patients without residual microcalcifications, 26 underwent surgical biopsy, 35 were not surgically treated and were managed conservatively with mammographic follow-up, and 4 had follow-up of less than 24 months.

RESULTS

In 41 patients with residual microcalcifications who underwent surgical biopsy, 8 malignant lesions were found at surgery. The underestimation rate was 20% (8/41). In 26 patients without residual microcalcifications who underwent surgical biopsy, no malignant lesions were found. One malignant lesion was found in the 35 patients managed conservatively at follow-up. The underestimation rate in patients without residual microcalcifications using surgical biopsy or mammographic follow-up as the reference standard was 1.6% (1/61).

CONCLUSION

Patients without residual microcalcifications after vacuum-assisted breast biopsy could possibly be managed in a conservative way with mammographic follow-up.

Authors+Show Affiliations

Department of Radiology, DICMI-University of Genova, Largo Rosanna Benzi 5, Genova 16132, Italy. dr.willa@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21940593

Citation

Villa, Alessandro, et al. "Atypical Ductal Hyperplasia Diagnosed at 11-gauge Vacuum-assisted Breast Biopsy Performed On Suspicious Clustered Microcalcifications: Could Patients Without Residual Microcalcifications Be Managed Conservatively?" AJR. American Journal of Roentgenology, vol. 197, no. 4, 2011, pp. 1012-8.
Villa A, Tagliafico A, Chiesa F, et al. Atypical ductal hyperplasia diagnosed at 11-gauge vacuum-assisted breast biopsy performed on suspicious clustered microcalcifications: could patients without residual microcalcifications be managed conservatively? AJR Am J Roentgenol. 2011;197(4):1012-8.
Villa, A., Tagliafico, A., Chiesa, F., Chiaramondia, M., Friedman, D., & Calabrese, M. (2011). Atypical ductal hyperplasia diagnosed at 11-gauge vacuum-assisted breast biopsy performed on suspicious clustered microcalcifications: could patients without residual microcalcifications be managed conservatively? AJR. American Journal of Roentgenology, 197(4), 1012-8. https://doi.org/10.2214/AJR.11.6588
Villa A, et al. Atypical Ductal Hyperplasia Diagnosed at 11-gauge Vacuum-assisted Breast Biopsy Performed On Suspicious Clustered Microcalcifications: Could Patients Without Residual Microcalcifications Be Managed Conservatively. AJR Am J Roentgenol. 2011;197(4):1012-8. PubMed PMID: 21940593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atypical ductal hyperplasia diagnosed at 11-gauge vacuum-assisted breast biopsy performed on suspicious clustered microcalcifications: could patients without residual microcalcifications be managed conservatively? AU - Villa,Alessandro, AU - Tagliafico,Alberto, AU - Chiesa,Fabio, AU - Chiaramondia,Maurizio, AU - Friedman,Daniele, AU - Calabrese,Massimo, PY - 2011/9/24/entrez PY - 2011/9/24/pubmed PY - 2011/12/13/medline SP - 1012 EP - 8 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 197 IS - 4 N2 - OBJECTIVE: The purpose of our study was to establish whether it might be safe for women with a diagnosis of atypical ductal hyperplasia (ADH) at stereotactically guided vacuum-assisted breast biopsy without any residual microcalcification after the procedure to undergo mammographic follow-up instead of surgical biopsy. MATERIALS AND METHODS: From October 2003 to January 2009, 1173 consecutive 11-gauge vacuum-assisted breast biopsy procedures were performed. ADH was found in the specimens of 114 patients who underwent vacuum-assisted breast biopsy for a single cluster of suspicious microcalcifications smaller than 15 mm; 49 had residual microcalcifications, and 65 had microcalcifications completely removed by the procedure. Of 49 patients with residual microcalcifications, 41 underwent surgical biopsy. Of 65 patients without residual microcalcifications, 26 underwent surgical biopsy, 35 were not surgically treated and were managed conservatively with mammographic follow-up, and 4 had follow-up of less than 24 months. RESULTS: In 41 patients with residual microcalcifications who underwent surgical biopsy, 8 malignant lesions were found at surgery. The underestimation rate was 20% (8/41). In 26 patients without residual microcalcifications who underwent surgical biopsy, no malignant lesions were found. One malignant lesion was found in the 35 patients managed conservatively at follow-up. The underestimation rate in patients without residual microcalcifications using surgical biopsy or mammographic follow-up as the reference standard was 1.6% (1/61). CONCLUSION: Patients without residual microcalcifications after vacuum-assisted breast biopsy could possibly be managed in a conservative way with mammographic follow-up. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/21940593/Atypical_ductal_hyperplasia_diagnosed_at_11_gauge_vacuum_assisted_breast_biopsy_performed_on_suspicious_clustered_microcalcifications:_could_patients_without_residual_microcalcifications_be_managed_conservatively L2 - https://www.ajronline.org/doi/10.2214/AJR.11.6588 DB - PRIME DP - Unbound Medicine ER -