Tags

Type your tag names separated by a space and hit enter

Vacuum assisted breast biopsy (VAB) excision of subcentimeter microcalcifications as an alternative to open biopsy for atypical ductal hyperplasia.
Br J Radiol. 2018 May; 91(1085):20180003.BJ

Abstract

OBJECTIVE

Atypical ductal hyperplasia (ADH) is a proliferative lesion associated with a variable increased risk of breast malignancy, but the management of the patients is still not completely defined, with mandatory surgical excision in most cases. To report the results of the conservative management with mammographic checks of patients with ADH diagnosed by vacuum assisted breast biopsy (VAB), without residual calcifications.

METHODS

The authors accessed the institutional database of radiological, surgical and pathological anatomy. Inclusion criteria were: ADH diagnosed by VAB on a single group of microcalcifications, without residual post-procedure; follow-up at least of 12 months. Exclusion criteria were the presence of personal history of breast cancer or other high-risk lesions; association with other synchronous lesions, both more and less advanced proliferative lesions.

RESULTS

The 65 included patients were all females, with age range of 40-79 years (mean 54 years). The maximum diameter range of the groups of microcalcifications was 4-11 mm (mean 6.2 mm), all classified as BI-RADS 4b (Breast Imaging Reporting and Data System 4b) and defined as fine pleomorphic in 29 cases (45%) or amorphous in 36 cases (55%). The range of follow-up length was 12-156 months (mean 67 months). Only one patients developed new microcalcifications, in the same breast, 48 months after and 15 mm from the first VAB, interpreted as low-grade ductal carcinoma in situ (DCIS) at surgical excision.

CONCLUSION

These results could justify the conservative management, in a selected group of patients, being the malignancy rate lower than 2%, considered in the literature as the "probably benign" definition. Advances in knowledge: Increasing the length of follow-up of selected patients conservatively managed can improve the management of ADH cases.

Authors+Show Affiliations

1 Department of Radiology, University of Genoa , Genoa , Italy.1 Department of Radiology, University of Genoa , Genoa , Italy.1 Department of Radiology, University of Genoa , Genoa , Italy.2 Department of Surgery, Policlinico San Martino , Genoa , Italy.3 Department of Radiology, Policlinico San Martino , Genoa , Italy.4 Department of Radiology, Ospedale San Bartolomeo , Sarzana , Italy.2 Department of Surgery, Policlinico San Martino , Genoa , Italy.1 Department of Radiology, University of Genoa , Genoa , Italy. 3 Department of Radiology, Policlinico San Martino , Genoa , Italy.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29451396

Citation

Schiaffino, Simone, et al. "Vacuum Assisted Breast Biopsy (VAB) Excision of Subcentimeter Microcalcifications as an Alternative to Open Biopsy for Atypical Ductal Hyperplasia." The British Journal of Radiology, vol. 91, no. 1085, 2018, p. 20180003.
Schiaffino S, Massone E, Gristina L, et al. Vacuum assisted breast biopsy (VAB) excision of subcentimeter microcalcifications as an alternative to open biopsy for atypical ductal hyperplasia. Br J Radiol. 2018;91(1085):20180003.
Schiaffino, S., Massone, E., Gristina, L., Fregatti, P., Rescinito, G., Villa, A., Friedman, D., & Calabrese, M. (2018). Vacuum assisted breast biopsy (VAB) excision of subcentimeter microcalcifications as an alternative to open biopsy for atypical ductal hyperplasia. The British Journal of Radiology, 91(1085), 20180003. https://doi.org/10.1259/bjr.20180003
Schiaffino S, et al. Vacuum Assisted Breast Biopsy (VAB) Excision of Subcentimeter Microcalcifications as an Alternative to Open Biopsy for Atypical Ductal Hyperplasia. Br J Radiol. 2018;91(1085):20180003. PubMed PMID: 29451396.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vacuum assisted breast biopsy (VAB) excision of subcentimeter microcalcifications as an alternative to open biopsy for atypical ductal hyperplasia. AU - Schiaffino,Simone, AU - Massone,Elena, AU - Gristina,Licia, AU - Fregatti,Piero, AU - Rescinito,Giuseppe, AU - Villa,Alessandro, AU - Friedman,Daniele, AU - Calabrese,Massimo, Y1 - 2018/02/23/ PY - 2018/2/17/pubmed PY - 2018/5/10/medline PY - 2018/2/17/entrez SP - 20180003 EP - 20180003 JF - The British journal of radiology JO - Br J Radiol VL - 91 IS - 1085 N2 - OBJECTIVE: Atypical ductal hyperplasia (ADH) is a proliferative lesion associated with a variable increased risk of breast malignancy, but the management of the patients is still not completely defined, with mandatory surgical excision in most cases. To report the results of the conservative management with mammographic checks of patients with ADH diagnosed by vacuum assisted breast biopsy (VAB), without residual calcifications. METHODS: The authors accessed the institutional database of radiological, surgical and pathological anatomy. Inclusion criteria were: ADH diagnosed by VAB on a single group of microcalcifications, without residual post-procedure; follow-up at least of 12 months. Exclusion criteria were the presence of personal history of breast cancer or other high-risk lesions; association with other synchronous lesions, both more and less advanced proliferative lesions. RESULTS: The 65 included patients were all females, with age range of 40-79 years (mean 54 years). The maximum diameter range of the groups of microcalcifications was 4-11 mm (mean 6.2 mm), all classified as BI-RADS 4b (Breast Imaging Reporting and Data System 4b) and defined as fine pleomorphic in 29 cases (45%) or amorphous in 36 cases (55%). The range of follow-up length was 12-156 months (mean 67 months). Only one patients developed new microcalcifications, in the same breast, 48 months after and 15 mm from the first VAB, interpreted as low-grade ductal carcinoma in situ (DCIS) at surgical excision. CONCLUSION: These results could justify the conservative management, in a selected group of patients, being the malignancy rate lower than 2%, considered in the literature as the "probably benign" definition. Advances in knowledge: Increasing the length of follow-up of selected patients conservatively managed can improve the management of ADH cases. SN - 1748-880X UR - https://www.unboundmedicine.com/medline/citation/29451396/Vacuum_assisted_breast_biopsy__VAB__excision_of_subcentimeter_microcalcifications_as_an_alternative_to_open_biopsy_for_atypical_ductal_hyperplasia_ DB - PRIME DP - Unbound Medicine ER -