Atypical ductal hyperplasia bordering on DCIS on core biopsy is associated with higher risk of upgrade than conventional
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EPIDEMIOLOGY
Atypical ductal hyperplasia bordering on DCIS on core biopsy is associated with higher risk of upgrade than conventional atypical ductal hyperplasia Kate R. Pawloski1 · Nicole Christian1 · Andrea Knezevic2 · Hannah Y. Wen3 · Kimberly J. Van Zee1 · Monica Morrow1 · Audree B. Tadros1 Received: 30 June 2020 / Accepted: 17 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Upgrade rates of conventional ADH are reported at 10–30%; however, rates for ADH bordering on DCIS (ADHBD) are largely unknown. We examined the upgrade rate of ADH-BD and core needle biopsy (CNB) features associated with upgrade. Surgical management in patients with concurrent ipsilateral breast cancer (BC) was also examined. Methods From 2000 to 2018, women with CNB diagnosis of ADH-BD were prospectively identified. Women with pure ADH-BD and concurrent ipsilateral ADH-BD/BC were analyzed separately, and upgrade rates were calculated. CNB features associated with upgrade and type of surgery were examined in women with pure ADH-BD; CNB features and concurrent pathology associated with upgrade were examined in women with ipsilateral BC. Results 108/236 (46%) patients with pure ADH-BD on CNB had DCIS (40%) or invasive carcinoma (6%) on surgical excision. DCIS or invasive carcinoma was more frequently found on excision of a mass that yielded ADH-BD on biopsy than excision of calcifications (65% vs 38%; p
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