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Surgical biopsy findings in patients with atypical hyperplasia diagnosed by stereotaxic core needle biopsy

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Abstract

Purpose: To correlate the stereotaxic core needle biopsy results with those of surgical biopsy in patients with atypical lobular or ductal hyperplasia (atypical hyperplasia) diagnosed at stereotaxic core needle biopsy (SCNB).

Methods: We retrospectively reviewed the mammograms and pathology reports of 358 consecutive SCNBs performed in 323 patients. The results of SCNBs of 22 lesions reported as atypical hyperplasia were correlated with histologic findings at surgical biopsy.

Results: A histologic diagnosis of atypical hyperplasia at SCNB was found to be a poor predictor of the final surgical results. In the 19 patients with 22 lesions, surgical biopsy and SCNB results were in disagreement in 16, partial agreement in two, and complete agreement in only four lesions. Furthermore, five cases of atypical hyperplasia were shown to have invasive carcinoma on open biopsy, and five had ductal carcinoma in situ in the surgical biopsy, none of which was present on SCNB.

Conclusion: Given the frequent occurrence of malignancy in patients diagnosed with atypical hyperplasia by SCNB, it is recommended that all such patients undergo excisional biopsy.

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References

  1. Parker SH, Lovin JD, Jobe WE, Burke BJ, Hopper KD, Yakes WF. Nonpalpable breast lesions: stereotactic automated large-core biopsies.Radiology 1991;180:403–7.

    CAS  PubMed  Google Scholar 

  2. Parker SH, Burbank F, Jackman RJ, et al. Percutaneous large-core breast biopsy: a multi-institutional study.Radiology 1994;193:359–64.

    CAS  PubMed  Google Scholar 

  3. Jackman RJ, Nowels KW, Shepard MJ, Finkelstein SI, Marzoni FA Jr. Stereotaxic large-core needle biopsy of 450 non-palpable breast lesions with surgical correlation in lesions with cancer or atypical hyperplasia.Radiology 1994;193:91–5.

    CAS  PubMed  Google Scholar 

  4. Liberman L, Evans WP III, Dershaw DD, et al. Atypical ductal hyperplasia diagnosed at stereotaxic core biopsy of breast lesions: an indication for surgical biopsy.AJR Am J Radiol 1995;164:1111–13.

    CAS  Google Scholar 

  5. Gisvold JJ, Goellner JR, Grant CS, et al. Breast biopsy: a comparative study of stereotaxically guided core and excisional techniques.AJR Am J Radiol 1994;162:815–20.

    CAS  Google Scholar 

  6. Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease.N Engl J Med 1985;312:146–51.

    CAS  PubMed  Google Scholar 

  7. Dupont WD, Parl FF, Hartmann WH, et al. Breast cancer risk associated with proliferative breast disease and atypical hyperplasia.Cancer 1993;71:1258–65.

    CAS  PubMed  Google Scholar 

  8. Page DL, Dupont WD. Anatomic markers of human premalignancy and risk of breast cancer.Cancer 1990;66:1326–36.

    CAS  PubMed  Google Scholar 

  9. London SJ, Connolly JL, Schnitt SJ, Colditz GA. A prospective study of benign breast disease and the risk of breast cancer.JAMA 1992;267:941–4.

    Article  CAS  PubMed  Google Scholar 

  10. Vilde F, Arkwright S. Lesions mammaires associees au cancer du sein; etude de deux cents pieces d'exerese.Ann Pathol 1987;7:279–84.

    CAS  PubMed  Google Scholar 

  11. Page DL, Anderson TJ.Diagnostic histopathology of the breast. New York: Churchill Livingstone, 1987:137–45.

    Google Scholar 

  12. Page DL, Zwaag RV, Rogers LW, et al. Relation between component parts of fibrocystic disease complex and breast cancer.J Natl Cancer Inst 1978;61:1055–63.

    CAS  PubMed  Google Scholar 

  13. Page D, Dupont WD, Rogers LW, Rados MS. Atypical hyperplastic lesions of the female breast: a long term follow-up study.Cancer 1985;55:2698–708.

    CAS  PubMed  Google Scholar 

  14. Page DL, Rogers LW. Combined histologic and cytologic criteria for the diagnosis of mammary atypical ductal hyperplasia.Hum Pathol 1992;23:1095–7.

    CAS  PubMed  Google Scholar 

  15. Tavassoli FA, Norris HJ. A comparison of the results of long-term follow-up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast.Cancer 1990;65:518–29.

    CAS  PubMed  Google Scholar 

  16. ACR breast imaging reporting and data system (BIRADS). Preston, VA.: ACR, 1992.

  17. Kopans DB. Caution on core.Radiology 1994;193:325–8.

    CAS  PubMed  Google Scholar 

  18. Rosai J. Borderline epithelial lesions of the breast.Am J Surg Pathol 1991;15(3):209–21.

    CAS  PubMed  Google Scholar 

  19. Bodian CA, Perzin KH, Lattes R, Hoffmann P. Reproducibility and validity of pathologic classifications of benign breast disease and implications for clinical applications.Cancer 1993;71:3908–13.

    CAS  PubMed  Google Scholar 

  20. Stomper PC, Cholewinski SP, Penetrante RB, Harlos JP, Tsangaris TN. Atypical hyperplasia: frequency and mammographic and pathologic relationships in excisional biopsies guided with mammography and clinical examination.Radiology 1993;189:667–71.

    CAS  PubMed  Google Scholar 

  21. Helvie MA, Hessler C, Frank TS, Ikeda DM. Atypical hyperplasia of the breast: mammographic appearance and histologic correlation.Radiology 1991;179:759–64.

    CAS  PubMed  Google Scholar 

  22. Lennington WJ, Jensen RA, Dalton LW, Page DL. Ductal carcinoma in situ of the breast: heterogeneity of individual lesions.Cancer 1994;73:118–24.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA

    Barbara M. Garcia MD & Darryl Carter MD

  2. Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar Street, PO Box 208042, Rm. 2-212 SP, 06520-8042, New Haven, CT, USA

    Irena Tocino MD

Authors
  1. Irena Tocino MD
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  2. Barbara M. Garcia MD
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  3. Darryl Carter MD
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Tocino, I., Garcia, B.M. & Carter, D. Surgical biopsy findings in patients with atypical hyperplasia diagnosed by stereotaxic core needle biopsy. Annals of Surgical Oncology 3, 483–488 (1996). https://doi.org/10.1007/BF02305767

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  • DOI: https://doi.org/10.1007/BF02305767

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