title: Atypical ductal hyperplasia of the breast: the controversial management of a borderline lesion: experience of 47 cases diagnosed at vacuum-assisted biopsy.
abstract: The present paper describes our experience of 47 cases of atypical ductal hyperplasia (ADH) diagnosed at vacuum-assisted biopsy. From June 1999 to December 2003, 47 consecutive diagnoses of non-palpable ADH of the breast were made by 11-gauge vacuum-assisted biopsy (Mammotome). Of these, 17 were subjected to surgical excision and 11 underwent a second Mammotome at the site of the previous vacuum-assisted biopsy. Diagnostic underestimation occurred in only two cases, with a surgical diagnosis of ductal carcinoma in situ. In both patients, aged between 46 and 55 years, the radiological images showed microcalcifications of >20 mm, and the lesions were not completely removed by Mammotome. Despite the obvious limitations of the present study, it can be concluded that the probability of underestimating ADH diagnosis by Mammotome appears to be related to the radiological features of the lesion (>20 mm) and to the adequacy of specimens.
authors.affiliation: Division of Oncology and Diagnostics, Morgagni-Pierantoni Hospital, via Forlanini 34, 47100 Forlì, Italy. l.bedei@ausl.fo.it
authors.forename: L
authors.initials: L
authors.lastname: Bedei
authors.forename: F
authors.initials: F
authors.lastname: Falcini
authors.forename: P A
authors.initials: PA
authors.lastname: Sanna
authors.forename: D
authors.initials: D
authors.lastname: Casadei Giunchi
authors.forename: M P
authors.initials: MP
authors.lastname: Innocenti
authors.forename: P
authors.initials: P
authors.lastname: Vignutelli
authors.forename: L
authors.initials: L
authors.lastname: Saragoni
authors.forename: S
authors.initials: S
authors.lastname: Folli
authors.forename: D
authors.initials: D
authors.lastname: Amadori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D014618:Vacuum