title: Diagnosis of Columnar Cell Lesions and Atypical Ductal Hyperplasia by Ultrasound-Guided Core Biopsy: Findings Associated with Underestimation of Breast Carcinoma.
abstract: The aim of the study described here was to determine underestimation rates and identify radiologic predictors of underestimation for columnar cell lesions (CCLs) and atypical ductal hyperplasia (ADH) detected by ultrasound-guided core needle biopsy. A total of 103 CCLs and ADH lesions in 100 patients diagnosed by ultrasound-guided core needle biopsy were evaluated. Breast sonographic and mammographic findings were reviewed, and underestimation rates were determined by surgical excision, percutaneous vacuum-assisted excision or 2-y imaging follow-up. All underestimated lesions were ductal carcinoma in situ, and the underestimation rates of flat epithelial atypia (FEA), FEA + ADH and ADH were 5.9% (1/17), 44.4% (4/9) and 27.3% (12/44), respectively. There was no underestimation of CCLs without atypia. The presence of calcifications on ultrasound was significantly associated with underestimation (p = 0.010). Therefore, except for CCLs without atypia, all other lesions may require excision, especially when calcification is present on ultrasound or when FEA + ADH is found.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea; Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Hye Shin
authors.initials: HS
authors.lastname: Ahn
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea. Electronic address: mjjang74@gmail.com.
authors.forename: Mijung
authors.initials: M
authors.lastname: Jang
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Bo La
authors.initials: BL
authors.lastname: Yun
authors.affiliation: Department of Surgery, Breast Care Center, Daerim St. Mary's Hospital, Seoul, Korea.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kang
authors.affiliation: Department of Pathology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D018084:Ultrasonography, Interventional / Q000379:methods*; D016217:Ultrasonography, Mammary; D055815:Young Adult
keywords: Atypical ductal hyperplasia; Breast ultrasound; Columnar cell lesion; Core needle biopsy; Underestimation