Safety of de-escalation of surgical intervention for atypical ductal hyperplasia on percutaneous biopsy: One size does not fit all.

Autor: Estrada J; The University of Kansas School of Medicine, Kansas City, KS, USA., Larson KE; Department of Surgery, The University of Kansas Health System, Kansas City, KS, USA., Kilgore LJ; Department of Surgery, The University of Kansas Health System, Kansas City, KS, USA., Wagner JL; Department of Surgery, The University of Kansas Health System, Kansas City, KS, USA., Winblad OD; Department of Radiology, The University of Kansas Health System, Kansas City, KS, USA., Balanoff CR; Department of Surgery, The University of Kansas Health System, Kansas City, KS, USA., Nye L; Department of Internal Medicine, The University of Kansas Health System, Kansas City, KS, USA., Amin AL; Department of Surgery, The University of Kansas Health System, Kansas City, KS, USA. Electronic address: Amanda.Amin@UHhospitals.org.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2023 Jan; Vol. 225 (1), pp. 21-25. Date of Electronic Publication: 2022 Sep 24.
DOI: 10.1016/j.amjsurg.2022.09.044
Abstrakt: Background: Oncologic safety of active monitoring (AM) for atypical ductal hyperplasia (ADH) on core-needle biopsy (CNB) is not well defined. We sought to define oncologic outcomes for AM to manage ADH meeting institutional predefined low-risk criteria (LOW).
Methods: ADH was diagnosed on CNB from 10/2015-03/2020. LOW (pure ADH, size <1 cm, >50% removed by CNB, <3 foci, and no necrosis) patients were offered AM; all others were recommended for surgical excision. Oncologic outcomes were compared for AM and surgery.
Results: 111 were included, 21 (19%) meeting LOW. AM occurred in 18 (86%) while 3 elected for excision (with 0% upgrade). Of the 18 LOW in AM, 2 required additional CNB (none at ADH site): 0% were diagnosed with cancer over median 23 month follow-up.
Conclusions: There were no missed cancers at ADH site during AM for LOW, confirming the oncologic safety of AM in this select group.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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