Doren E, Hulvat M, Norton J, Rajan P, Sarker S, Aranha G, and Yao K
American Journal Of Surgery [Am J Surg] 2008 Mar; Vol. 195 (3), pp. 358-61; discussion 361-2.
Adult, Aged, Aged, 80 and over, Biopsy, Female, Humans, Hyperplasia, Middle Aged, Predictive Value of Tests, Retrospective Studies, Breast pathology, Breast Neoplasms pathology, and Carcinoma, Intraductal, Noninfiltrating pathology
Background: There are no specific histopathologic factors that allow identification of patients with atypical ductal hyperplasia (ADH) who will have cancer on final excision. Methods: This was a retrospective study of all patients who had ADH on biopsy followed by excision from 1999 to 2006. Results: Fifty-one patients were found to have ADH on core biopsy. Eight (15.7%) patients had invasive carcinoma on surgical excision, 9 (17.5%) had ductal carcinoma-in-situ (DCIS), 21 (41.5%) had ADH, 4 (8%) patients had atypical lobular hyperplasia, and 9 (17.5%) had benign tumors. The grade of atypia on the core biopsy was mild in 13 (25%) patients, moderate in 22 (43%), and marked in 16 (32%). On multivariate analysis of histopathologic factors, the grade of atypia was the only significant variable that predicted a diagnosis of cancer on final surgical excision (P = .001). Conclusions: The grade of atypia correlated with the presence of cancer on surgical excision.