Clinical predictors of malignancy in patients diagnosed with atypical ductal hyperplasia on vacuum-assisted core needle biopsy
| Autor: | Diana Hodorowicz-Zaniewska, Wojciech Kibil, Andrzej Matyja, Katarzyna Dyląg-Trojanowska, Joanna Szpor, Antoni M. Szczepanik, Karolina Brzuszkiewicz, Piotr Richter |
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| Rok vydání: | 2018 |
| Předmět: |
Breast biopsy
medicine.medical_specialty Urology atypical ductal hyperplasia Malignancy 030218 nuclear medicine & medical imaging Lesion 03 medical and health sciences 0302 clinical medicine Biopsy medicine Mammography Medical history Original Paper medicine.diagnostic_test business.industry Gastroenterology Obstetrics and Gynecology Cancer vacuum-assisted core needle biopsy medicine.disease 030220 oncology & carcinogenesis Surgery Radiology medicine.symptom Breast carcinoma business breast cancer underestimation |
| Zdroj: | Videosurgery and other Miniinvasive Techniques |
| ISSN: | 1895-4588 |
| DOI: | 10.5114/wiitm.2018.73528 |
| Popis: | Introduction Atypical ductal hyperplasia (ADH) is a benign lesion, which due to the risk of coexisting cancer is classified as a lesion of uncertain malignant potential. Aim To identify clinical predictors of cancer underestimation in patients with ADH diagnosed after vacuum-assisted breast biopsy (VABB). Material and methods Between 2001 and 2016, a total of 3804 vacuum-assisted core needle biopsies were performed at the First Chair of General Surgery of the Jagiellonian University Medical College in Krakow, including 2907 ultrasound (US)-guided biopsies and 897 digital stereotactic procedures. Seventy-six women were diagnosed with ADH and 72 of them underwent subsequent surgical excision. Demographic factors, medical history, family history, clinical symptoms, type and size of lesion determined in imaging scans, size of biopsy needle, and presence of coexisting lesions in VABB specimens were analysed as potential predictors of malignancy underestimation. Results Underestimation of breast carcinoma occurred in 21 (29.2%) patients. The upgrade rate was significantly higher only in patients with a lesion visible both in mammography (MMG) and US examinations and combined BIRADS-5. Conclusions Vacuum-assisted core needle biopsy is a minimally invasive technique used in diagnosing ADH. As the risk of breast malignancy underestimation is relatively high, open surgical biopsy remains the recommended procedure, especially in patients with lesions detected both in mammography and US examination. As we could not identify the factors that preclude cancer underestimation, all the women diagnosed with ADH should be informed about the risk of cancer underestimation. |
| Databáze: | OpenAIRE |
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