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Atypical ductal hyperplasia of the breast diagnosed by ultrasonographically guided core needle biopsy.
Ultraschall Med. 2012 Oct; 33(5):447-54.UM

Abstract

PURPOSE

We analysed the ultrasonographic (US) features of atypical ductal hyperplasia (ADH) of the breast diagnosed by US-guided core needle biopsy (CNB) with the aim of identifying factors that affect the underestimation of ADH.

MATERIALS AND METHODS

A total of 134 ADH lesions sampled by US-guided CNB were reviewed retrospectively. All lesions were evaluated for pattern, size, lesion characteristics and margins, and the corresponding surgical outcome or imaging follow-up was obtained. Each patient's clinical and radiological features were analysed to identify factors involved in ADH underestimation.

RESULTS

The prevalence of malignancy in each pattern of lesions following surgical excision was 32/81 (40%) for solid masses, 14/31 (45%) for ductal patterns, 5/17 (29%) for complex cystic lesions and 2/5 (40%) for architectural distortions. Based on the results of surgical and US follow-up, none of the category 3 lesions was proven to be a malignancy. Malignancy was found in 17 (21%) of the 80 BI-RADS (Breast Imaging Reporting and Data System) category 4a lesions, 20 (74%) of the 27 category 4b lesions, 12 (92%) of the 13 category 4c lesions, and four (100%) of the four category 5 lesions. Lesions with a higher US assessment category, lacking circumscribed margins, or a mammographic finding of suspected malignancy were all significantly associated with underestimation (p < 0.05 for each).

CONCLUSION

US is useful in evaluating ADH lesions and in clarifying the indication for biopsy of these lesions. Familiarity with the frequency associated with malignancy for each feature will improve the utility of US in the work-up of these breast abnormalities.

Authors+Show Affiliations

Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. hsianhe@yahoo.com.twNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22161618

Citation

Hsu, H-H, et al. "Atypical Ductal Hyperplasia of the Breast Diagnosed By Ultrasonographically Guided Core Needle Biopsy." Ultraschall in Der Medizin (Stuttgart, Germany : 1980), vol. 33, no. 5, 2012, pp. 447-54.
Hsu HH, Yu JC, Hsu GC, et al. Atypical ductal hyperplasia of the breast diagnosed by ultrasonographically guided core needle biopsy. Ultraschall Med. 2012;33(5):447-54.
Hsu, H. H., Yu, J. C., Hsu, G. C., Yu, C. P., Chang, W. C., Tung, H. J., Lin, W. C., Tsai, S. H., & Huang, G. S. (2012). Atypical ductal hyperplasia of the breast diagnosed by ultrasonographically guided core needle biopsy. Ultraschall in Der Medizin (Stuttgart, Germany : 1980), 33(5), 447-54.
Hsu HH, et al. Atypical Ductal Hyperplasia of the Breast Diagnosed By Ultrasonographically Guided Core Needle Biopsy. Ultraschall Med. 2012;33(5):447-54. PubMed PMID: 22161618.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atypical ductal hyperplasia of the breast diagnosed by ultrasonographically guided core needle biopsy. AU - Hsu,H-H, AU - Yu,J-C, AU - Hsu,G-C, AU - Yu,C-P, AU - Chang,W-C, AU - Tung,H-J, AU - Lin,W-C, AU - Tsai,S-H, AU - Huang,G-S, Y1 - 2011/12/09/ PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2013/4/2/medline SP - 447 EP - 54 JF - Ultraschall in der Medizin (Stuttgart, Germany : 1980) JO - Ultraschall Med VL - 33 IS - 5 N2 - PURPOSE: We analysed the ultrasonographic (US) features of atypical ductal hyperplasia (ADH) of the breast diagnosed by US-guided core needle biopsy (CNB) with the aim of identifying factors that affect the underestimation of ADH. MATERIALS AND METHODS: A total of 134 ADH lesions sampled by US-guided CNB were reviewed retrospectively. All lesions were evaluated for pattern, size, lesion characteristics and margins, and the corresponding surgical outcome or imaging follow-up was obtained. Each patient's clinical and radiological features were analysed to identify factors involved in ADH underestimation. RESULTS: The prevalence of malignancy in each pattern of lesions following surgical excision was 32/81 (40%) for solid masses, 14/31 (45%) for ductal patterns, 5/17 (29%) for complex cystic lesions and 2/5 (40%) for architectural distortions. Based on the results of surgical and US follow-up, none of the category 3 lesions was proven to be a malignancy. Malignancy was found in 17 (21%) of the 80 BI-RADS (Breast Imaging Reporting and Data System) category 4a lesions, 20 (74%) of the 27 category 4b lesions, 12 (92%) of the 13 category 4c lesions, and four (100%) of the four category 5 lesions. Lesions with a higher US assessment category, lacking circumscribed margins, or a mammographic finding of suspected malignancy were all significantly associated with underestimation (p < 0.05 for each). CONCLUSION: US is useful in evaluating ADH lesions and in clarifying the indication for biopsy of these lesions. Familiarity with the frequency associated with malignancy for each feature will improve the utility of US in the work-up of these breast abnormalities. SN - 1438-8782 UR - https://www.unboundmedicine.com/medline/citation/22161618/Atypical_ductal_hyperplasia_of_the_breast_diagnosed_by_ultrasonographically_guided_core_needle_biopsy_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1245877 DB - PRIME DP - Unbound Medicine ER -