The significance of surgical margins for patients with atypical ductal hyperplasia.
BACKGROUND
The significance of surgical margins for patients with atypical ductal hyperplasia is unknown.


METHODS
We reviewed our experience with atypical ductal hyperplasia and correlated the margin status of the specimens removed with the risk of recurrence as atypical ductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma. Seven hundred forty-seven patients were identified between February 1995 and September 2005 as having biopsy proven atypical ductal hyperplasia (ADH). One hundred fifty-five of these patients were found to have "pure" atypical ductal hyperplasia without associated premalignant or malignant breast disease or a history of ipsilateral disease. Margin status of the initial excisional biopsy was noted and was correlated with the risk of recurrence.


RESULTS
Of the 155 patients whose excisional biopsy specimens were "pure" atypical ductal hyperplasia, 44% (68) had negative margins, 5% (7) had positive margins, and 52% (80) were not reported. No patient underwent re-excision for close or positive margins. Follow-up ranged from 0 to 119 months, with a mean of 26 months. Seven patients (5%) presented with new findings at the site of their initial excisional biopsy, 1 of whom was found to have an invasive ductal carcinoma and 6 of whom had benign findings. Of the 87 patients with margins positive or unknown for ADH at surgical excision, none went on to develop malignancy.


CONCLUSIONS
Our results suggest that clear surgical margins at surgical excision for atypical ductal hyperplasia did not affect the risk of subsequently developing a malignancy.
Greene
Tobi
T
Department of Surgery, Division of Breast Oncology, St. Luke's Roosevelt Hospital, 425 W 59th St, Suite 7A, New York, NY 10019, USA.
Tartter
Paul Ian
PI
Smith
Sharon Rosenbaum
SR
Estabrook
Alison
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000209:etiology*; D018270:Carcinoma, Ductal, Breast / Q000209:etiology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000601:surgery; D042361:Mammary Glands, Human / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors