Atypical hyperplasia: frequency and mammographic and pathologic relationships in excisional biopsies guided with mammography and clinical examination.
OBJECTIVE
To ascertain the frequency and pathologic relationships of atypical hyperplasia in biopsy specimens obtained after clinical and mammographic examination.


METHODS
Clinical, mammographic, and histologic findings were prospectively correlated in 300 consecutive excisional biopsies.


RESULTS
Atypical hyperplasia was detected in 26 (17%) of 154 biopsies with benign findings and 19 (13%) of 146 biopsies with malignant findings overall (P > .05). The frequency of atypical hyperplasia was only 4% (two of 55 specimens) in clinically prompted biopsies with benign findings but 24% (24 of 99 specimens) in mammographically prompted biopsies with benign findings (P = .002), increasing to 31% (21 of 68 specimens) in benign microcalcifications and 40% (18 of 45 specimens) in benign microcalcifications associated with adenosis. Atypical hyperplasia was found most often within (16 [62%] of 26 cases) or adjacent to (nine [35%] of 26 cases) another lesion that prompted biopsy.


CONCLUSIONS
Most atypical hyperplasia is not a random finding in benign biopsy specimens but shows a statistically significantly greater frequency in association with microcalcifications detected with mammography only, especially those in areas of adenosis.
Stomper
P C
PC
Department of Diagnostic Radiology, Roswell Park Cancer Institute.
Cholewinski
S P
SP
Penetrante
R B
RB
Harlos
J P
JP
Tsangaris
T N
TN
D001706:Biopsy / Q000379:methods; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D008327:Mammography; D008875:Middle Aged; D010808:Physical Examination; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors