Is surgical excision necessary for atypical ductal hyperplasia of the breast diagnosed by Mammotome?
BACKGROUND
Core biopsy findings of atypical ductal hyperplasia (ADH) underestimates the diagnosis of malignancy by 18% to 88%. Using the Mammotome biopsy technique, more accurate assessment of the lesion is possible, making selective excision of these lesions a consideration.


METHODS
The records of 62 patients who were found to have ADH at Mammotome biopsy and subsequently underwent excision of the lesion were reviewed. Patient data were statistically analyzed for predictors of malignancy at the time of surgical excision.


RESULTS
Of the 62 patients, 9 (15%) had malignancy at excision. Variables predicting for malignancy included markedly atypical hyperplasia and incomplete removal of calcifications at Mammotome biopsy, a previous contralateral breast cancer, and a family history of breast cancer, with a combined sensitivity of 100% and specificity of 80%.


CONCLUSIONS
Mild ADH found on Mammotome, not associated with a personal or family history of breast cancer, may not need excision if all calcifications have been removed.
Adrales
G
G
Carolinas Medical Center, Charlotte, North Carolina, USA.
Turk
P
P
Wallace
T
T
Bird
R
R
Norton
H J
HJ
Greene
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology; D002114:Calcinosis / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity