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Long term clinical follow-up of atypical ductal hyperplasia and lobular carcinoma in situ in breast core needle biopsies.
Pathology. 2016 Jan; 48(1):25-9.P

Abstract

Atypical ductal hyperplasia (ADH) and lobular carcinoma in situ (LCIS) may be associated with a relatively high incidence of invasive carcinoma and ductal carcinoma in situ (DCIS) on immediate excision when found on core needle biopsy of the breast. However, the long term significance of ADH and LCIS in a breast core needle biopsy is not as well characterised. We reviewed the results of all breast core needle biopsies with a diagnosis of ADH or LCIS and immediate excision from the years 2000-2004, and correlated the results with long term clinical follow-up. Of 175 biopsies with ADH, 53 (30.3%) had carcinoma (8 invasive, and 45 DCIS) at the time of immediate re-excision. Of 69 biopsies with LCIS, three (4.3%) had carcinoma (2 invasive, and 1 DCIS) at the time of immediate re-excision. A total of 14 (11.5%) patients with ADH and benign re-excisions developed invasive carcinoma (12) or DCIS (2) on follow-up. A total of 17 (25.8%) patients with LCIS and benign re-excisions developed invasive carcinoma (13) or DCIS (4) on follow-up. The risk of invasive carcinoma or DCIS on immediate re-excision was significantly higher for women with ADH than LCIS (p<0.001). Women with LCIS developed significantly more invasive carcinomas and DCIS than women with ADH on long term follow-up (p=0.01). Compared to women with fibrocystic changes (FCC) on core needle biopsy, the risk of developing invasive carcinoma or DCIS was significantly higher for women with ADH and benign initial re-excisions (95% CI 1.092-7.297, p=0.03), and women with LCIS and benign re-excisions (95% CI 3.028-18.657, p<0.001). Overall, 67/175 (38.3%) women with ADH and 20/69 (29.0%) women with LCIS on core needle biopsy either had carcinoma at the time of the biopsy or later developed carcinoma. Significantly more women with LCIS developed invasive carcinoma or DCIS than women with ADH on long term follow-up. The relative risk for ADH and LCIS on core biopsy with a negative excision compared with FCC was similar to that reported in the literature (ADH 1-7×, LCIS 3-19×).

Authors+Show Affiliations

Department of Pathology, Baptist Hospital of Miami, Miami, FL, United States. Electronic address: andrewr@baptisthealth.net.Department of Pathology, Baptist Hospital of Miami, Miami, FL, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27020205

Citation

Renshaw, Andrew A., and Edwin W. Gould. "Long Term Clinical Follow-up of Atypical Ductal Hyperplasia and Lobular Carcinoma in Situ in Breast Core Needle Biopsies." Pathology, vol. 48, no. 1, 2016, pp. 25-9.
Renshaw AA, Gould EW. Long term clinical follow-up of atypical ductal hyperplasia and lobular carcinoma in situ in breast core needle biopsies. Pathology. 2016;48(1):25-9.
Renshaw, A. A., & Gould, E. W. (2016). Long term clinical follow-up of atypical ductal hyperplasia and lobular carcinoma in situ in breast core needle biopsies. Pathology, 48(1), 25-9. https://doi.org/10.1016/j.pathol.2015.11.015
Renshaw AA, Gould EW. Long Term Clinical Follow-up of Atypical Ductal Hyperplasia and Lobular Carcinoma in Situ in Breast Core Needle Biopsies. Pathology. 2016;48(1):25-9. PubMed PMID: 27020205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long term clinical follow-up of atypical ductal hyperplasia and lobular carcinoma in situ in breast core needle biopsies. AU - Renshaw,Andrew A, AU - Gould,Edwin W, Y1 - 2015/12/14/ PY - 2015/07/19/received PY - 2015/09/01/revised PY - 2015/09/06/accepted PY - 2016/3/30/entrez PY - 2016/3/30/pubmed PY - 2018/2/8/medline KW - Breast KW - LCIS KW - atypical ductal hyperplasia KW - biopsy KW - carcinoma KW - core needle biopsy KW - follow-up KW - mammotomy KW - neoplasia SP - 25 EP - 9 JF - Pathology JO - Pathology VL - 48 IS - 1 N2 - Atypical ductal hyperplasia (ADH) and lobular carcinoma in situ (LCIS) may be associated with a relatively high incidence of invasive carcinoma and ductal carcinoma in situ (DCIS) on immediate excision when found on core needle biopsy of the breast. However, the long term significance of ADH and LCIS in a breast core needle biopsy is not as well characterised. We reviewed the results of all breast core needle biopsies with a diagnosis of ADH or LCIS and immediate excision from the years 2000-2004, and correlated the results with long term clinical follow-up. Of 175 biopsies with ADH, 53 (30.3%) had carcinoma (8 invasive, and 45 DCIS) at the time of immediate re-excision. Of 69 biopsies with LCIS, three (4.3%) had carcinoma (2 invasive, and 1 DCIS) at the time of immediate re-excision. A total of 14 (11.5%) patients with ADH and benign re-excisions developed invasive carcinoma (12) or DCIS (2) on follow-up. A total of 17 (25.8%) patients with LCIS and benign re-excisions developed invasive carcinoma (13) or DCIS (4) on follow-up. The risk of invasive carcinoma or DCIS on immediate re-excision was significantly higher for women with ADH than LCIS (p<0.001). Women with LCIS developed significantly more invasive carcinomas and DCIS than women with ADH on long term follow-up (p=0.01). Compared to women with fibrocystic changes (FCC) on core needle biopsy, the risk of developing invasive carcinoma or DCIS was significantly higher for women with ADH and benign initial re-excisions (95% CI 1.092-7.297, p=0.03), and women with LCIS and benign re-excisions (95% CI 3.028-18.657, p<0.001). Overall, 67/175 (38.3%) women with ADH and 20/69 (29.0%) women with LCIS on core needle biopsy either had carcinoma at the time of the biopsy or later developed carcinoma. Significantly more women with LCIS developed invasive carcinoma or DCIS than women with ADH on long term follow-up. The relative risk for ADH and LCIS on core biopsy with a negative excision compared with FCC was similar to that reported in the literature (ADH 1-7×, LCIS 3-19×). SN - 1465-3931 UR - https://www.unboundmedicine.com/medline/citation/27020205/Long_term_clinical_follow_up_of_atypical_ductal_hyperplasia_and_lobular_carcinoma_in_situ_in_breast_core_needle_biopsies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0031-3025(15)00016-1 DB - PRIME DP - Unbound Medicine ER -