Annals of Surgical Oncology, Vol 4, Issue 4 283-286, Copyright © 1997 by Society of Surgical Oncology

ARTICLES

Appropriate management of atypical ductal hyperplasia diagnosed by stereotactic core needle breast biopsy

D. E. Gadzala, G. J. Cederbom, J. S. Bolton, W. M. McKinnon, G. H. Farr Jr, J. Champaign, K. Ordoyne, K. Chung and G. M. Fuhrman
Department of Surgery, Ochsner Clinic, New Orleans, LA 70121, USA.

BACKGROUND: Stereotactic core needle breast biopsy (SCNBB) is a minimally invasive technique used to sample nonpalpable mammographic abnormalities. The optimal management of atypical ductal hyperplasia (ADH) diagnosed by SCNBB is unknown. We hypothesized that ADH diagnosed by SCNBB should be evaluated by excisional breast biopsy (EBB) because of the risk of identifying carcinoma in association with ADH that would be missed if a diagnostic sampling technique alone was utilized. METHODS: To test this hypothesis, a prospective diagnostic protocol was created which called for SCNBB instead of EBB for patients with mammographic abnormalities considered suspicious for malignancy. If ADH was noted on histologic evaluation of the cores, patients were advised to undergo an EBB. RESULTS: A review of the initial 900 patients evaluated by SCNBB yielded 39 patients (4.3%) with ADH detected by SCNBB. Thirty-six of these 39 patients agreed to proceed with EBB: 19 patients demonstrated benign findings including atypical ductal hyperplasia, 13 patients demonstrated noninvasive ductal carcinoma, and 4 patients had evidence of invasive carcinoma. CONCLUSIONS: A 47% rate of detecting noninvasive or invasive breast carcinoma supports the hypothesis that ADH detected by a sampling technique, such as SCNBB, should be managed by EBB.

This article has been cited by other articles:

				M. Rizzo, M. J. Lund, G. Oprea, M. Schniederjan, W. C Wood, and M. Mosunjac Surgical Follow-Up and Clinical Presentation of 142 Breast Papillary Lesions Diagnosed by Ultrasound-Guided Core-Needle Biopsy Ann. Surg. Oncol., April 1, 2008; 15(4): 1040 - 1047. [Abstract] [Full Text] [PDF]

				A. G Douglas-Jones, J. L Denson, A. C Cox, I. B Harries, and G. Stevens Radial scar lesions of the breast diagnosed by needle core biopsy: analysis of cases containing occult malignancy J. Clin. Pathol., March 1, 2007; 60(3): 295 - 298. [Abstract] [Full Text] [PDF]

				R. J. Jackman, R. L. Birdwell, and D. M. Ikeda Atypical Ductal Hyperplasia: Can Some Lesions Be Defined as Probably Benign after Stereotactic 11-gauge Vacuum-assisted Biopsy, Eliminating the Recommendation for Surgical Excision? Radiology, August 1, 2002; 224(2): 548 - 554. [Abstract] [Full Text] [PDF]

				R. J. Jackman, F. Burbank, S. H. Parker, W. P. Evans III, M. C. Lechner, T. R. Richardson, A. A. Smid, H. B. Borofsky, C. H. Lee, H. M. Goldstein, et al. Stereotactic Breast Biopsy of Nonpalpable Lesions: Determinants of Ductal Carcinoma in Situ Underestimation Rates Radiology, February 1, 2001; 218(2): 497 - 502. [Abstract] [Full Text]

				M. L. R. Darling, D. N. Smith, S. C. Lester, C. Kaelin, D.-L. G. Selland, C. M. Denison, P. J. DiPiro, D. I. Rose, E. Rhei, and J. E. Meyer Atypical Ductal Hyperplasia and Ductal Carcinoma In Situ as Revealed by Large-Core Needle Breast Biopsy: Results of Surgical Excision Am. J. Roentgenol., November 1, 2000; 175(5): 1341 - 1346. [Abstract] [Full Text] [PDF]

				H. E. Reynolds Core Needle Biopsy of Challenging Benign Breast Conditions: A Comprehensive Literature Review Am. J. Roentgenol., May 1, 2000; 174(5): 1245 - 1250. [Full Text] [PDF]

				R. J. Jackman, K. W. Nowels, J. Rodriguez-Soto, F. A. Marzoni Jr, S. I. Finkelstein, and M. J. Shepard Stereotactic, Automated, Large-Core Needle Biopsy of Nonpalpable Breast Lesions: False-Negative and Histologic Underestimation Rates after Long-term Follow-up Radiology, March 1, 1999; 210(3): 799 - 805. [Abstract] [Full Text]