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The risk of upgrade for atypical ductal hyperplasia detected on magnetic resonance imaging-guided biopsy: a study of 100 cases from four academic institutions.
Histopathology. 2016 Apr; 68(5):713-21.H

Abstract

AIMS

To identify variables that can predict upgrade for magnetic resonance imaging (MRI)-detected atypical ductal hyperplasia (ADH).

METHODS AND RESULTS

We reviewed 1655 MRI-guided core biopsies between 2005 and 2013, yielding 100 (6%) cases with ADH. The pathological features of ADH and MRI findings were recorded. An upgrade was considered when the subsequent surgical excision yielded invasive carcinoma (IC) or ductal carcinoma in situ (DCIS). The rate of ADH between institutions was 3.3-7.1%, with an average of 6%. A total of 15 (15%) cases had upgrade, 12 DCIS and three IC. When all cases were included, only increased number of involved cores was statistically significant (P = 0.02). When cases with concurrent lobular neoplasia (LN) were excluded (n = 14), increased number of ADH foci and increased number of involved cores were statistically significant (P = 0.002, P = 0.009). We analysed the data separately from a single institution (n = 61). Increased number of foci, increased number of total cores and involved cores and larger ADH size predicted upgrade with statistical significance.

CONCLUSIONS

The incidence of ADH in MRI-guided core biopsy is rare. The rate of upgrade is comparable to mammographically detected ADH, warranting surgical excision. Similar to mammographically detected lesions, the volume of the ADH predicts the upgrade.

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Authors+Show Affiliations

Khoury T
Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY, USA.
Li Z
Department of Pathology, Ohio State University, Columbus, OH, USA.
Sanati S
Department of Pathology, Washington University, St Louis, MO, USA.
Desouki MM
Department of Pathology, Vanderbilt University, Nashville, TN, USA.
Chen X
Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA.
Wang D
Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA.
Liu S
Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA.
Karabakhtsian R
Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Kumar P
Department of Radiology, Roswell Park Cancer Institute, Buffalo, NY, USA.
Reig B
Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

MeSH

AdultAgedBiopsy, Large-Core NeedleBreast NeoplasmsCarcinoma, Intraductal, NoninfiltratingFemaleHumansImage-Guided BiopsyMagnetic Resonance ImagingMammographyMiddle AgedNeoplasm GradingRisk

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26291517

Citation

Khoury, Thaer, et al. "The Risk of Upgrade for Atypical Ductal Hyperplasia Detected On Magnetic Resonance Imaging-guided Biopsy: a Study of 100 Cases From Four Academic Institutions." Histopathology, vol. 68, no. 5, 2016, pp. 713-21.
Khoury T, Li Z, Sanati S, et al. The risk of upgrade for atypical ductal hyperplasia detected on magnetic resonance imaging-guided biopsy: a study of 100 cases from four academic institutions. Histopathology. 2016;68(5):713-21.
Khoury, T., Li, Z., Sanati, S., Desouki, M. M., Chen, X., Wang, D., Liu, S., Karabakhtsian, R., Kumar, P., & Reig, B. (2016). The risk of upgrade for atypical ductal hyperplasia detected on magnetic resonance imaging-guided biopsy: a study of 100 cases from four academic institutions. Histopathology, 68(5), 713-21. https://doi.org/10.1111/his.12811
Khoury T, et al. The Risk of Upgrade for Atypical Ductal Hyperplasia Detected On Magnetic Resonance Imaging-guided Biopsy: a Study of 100 Cases From Four Academic Institutions. Histopathology. 2016;68(5):713-21. PubMed PMID: 26291517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The risk of upgrade for atypical ductal hyperplasia detected on magnetic resonance imaging-guided biopsy: a study of 100 cases from four academic institutions. AU - Khoury,Thaer, AU - Li,Zaibo, AU - Sanati,Souzan, AU - Desouki,Mohamed M, AU - Chen,Xiwei, AU - Wang,Dan, AU - Liu,Song, AU - Karabakhtsian,Rouzan, AU - Kumar,Prasanna, AU - Reig,Beatriu, Y1 - 2015/10/05/ PY - 2015/05/12/received PY - 2015/08/14/accepted PY - 2015/8/21/entrez PY - 2015/8/21/pubmed PY - 2018/2/27/medline KW - atypical ductal hyperplasia KW - breast KW - magnetic resonance imaging KW - upgrade SP - 713 EP - 21 JF - Histopathology JO - Histopathology VL - 68 IS - 5 N2 - AIMS: To identify variables that can predict upgrade for magnetic resonance imaging (MRI)-detected atypical ductal hyperplasia (ADH). METHODS AND RESULTS: We reviewed 1655 MRI-guided core biopsies between 2005 and 2013, yielding 100 (6%) cases with ADH. The pathological features of ADH and MRI findings were recorded. An upgrade was considered when the subsequent surgical excision yielded invasive carcinoma (IC) or ductal carcinoma in situ (DCIS). The rate of ADH between institutions was 3.3-7.1%, with an average of 6%. A total of 15 (15%) cases had upgrade, 12 DCIS and three IC. When all cases were included, only increased number of involved cores was statistically significant (P = 0.02). When cases with concurrent lobular neoplasia (LN) were excluded (n = 14), increased number of ADH foci and increased number of involved cores were statistically significant (P = 0.002, P = 0.009). We analysed the data separately from a single institution (n = 61). Increased number of foci, increased number of total cores and involved cores and larger ADH size predicted upgrade with statistical significance. CONCLUSIONS: The incidence of ADH in MRI-guided core biopsy is rare. The rate of upgrade is comparable to mammographically detected ADH, warranting surgical excision. Similar to mammographically detected lesions, the volume of the ADH predicts the upgrade. SN - 1365-2559 UR - https://www.unboundmedicine.com/medline/citation/26291517/The_risk_of_upgrade_for_atypical_ductal_hyperplasia_detected_on_magnetic_resonance_imaging_guided_biopsy:_a_study_of_100_cases_from_four_academic_institutions_ DB - PRIME DP - Unbound Medicine ER -