Atypical ductal hyperplasia diagnosed at stereotaxic core biopsy of breast lesions: an indication for surgical biopsy.

Overview

OBJECTIVE: The purpose of this study was to evaluate the prevalence of carcinoma found at surgical biopsy of lesions identified as atypical ductal hyperplasia by stereotaxic core breast biopsy. SUBJECTS AND METHODS: Stereotaxic core biopsies of 264 mammographically evident lesions were done with the patients lying prone on a dedicated stereotaxic table, with an automated gun and a 14-gauge needle. Atypical ductal hyperplasia was identified in 25 (9%) of 264 lesions, including four (3%) of 159 masses and 21 (20%) of 105 lesions evident as calcifications. Surgical biopsy was recommended in all 25 of these cases and was performed in 21. Results of stereotaxic core biopsy and surgery in these 21 cases were reviewed and correlated. RESULTS: Of 21 cases identified as atypical ductal hyperplasia at stereotaxic core biopsy that were subsequently evaluated with surgical biopsy, histopathologic analysis of the surgical specimen yielded benign histologic findings without atypia in four (19%), atypical ductal hyperplasia in six (29%), and carcinoma in 11 (52%). Of the 11 carcinomas, histologic findings showed ductal carcinoma in situ in eight (73%) and invasive ductal carcinoma in three (27%). CONCLUSION: The finding of atypical ductal hyperplasia at stereotaxic core breast biopsy is an indication for surgical biopsy because of the high prevalence of ductal carcinoma in these lesions.