J Breast Cancer.  2010 Jun;13(2):132-137. 10.4048/jbc.2010.13.2.132.

Factors in the Breast Core Needle Biopsies of Atypical Ductal Hyperplasia that Can Predict Carcinoma in the Subsequent Surgical Excision Specimens

• Koo JS
• Kim MJ
• Kim EK
• Jung W

• KMID: 2286537
• DOI: http://doi.org/10.4048/jbc.2010.13.2.132

Abstract

PURPOSE
Our purpose was to identify the factors in a breast core needle biopsy (CNB) of atypical ductal hyperplasia (ADH) that are predictive for carcinoma in the subsequent excision specimens.
METHODS
We performed a retrospective pathologic review of 50 cases that were diagnosed as ADH via the CNB and that had the corresponding excision specimens.
RESULTS
The size of the largest ADH foci in the CNBs was 0.8+/-0.6 mm (mean+/-SD) for benign proliferative disease (BPD, n=12), 1.0+/-0.5 mm (mean+/-SD) for ADH (n=9) and 1.3+/-0.8 mm (mean+/-SD) for malignant lesions (n=29) in excision specimens (p=0.105). Among the 30 cases showing stromal alterations around the ducts with ADH in the CNBs, 9 cases (30.0%) were BPD or ADH and 21 cases (70.0%) were malignant lesions in the excision specimens (p=0.004).
CONCLUSION
As the stromal alterations around the ADH were noted in the CNB, there was an increased likelihood that more advanced lesions would be identified in the surgical excision specimens.

Keyword

Breast hyperplasia; Needle biopsy; Risk factor

MeSH Terms

Biopsy, Large-Core Needle
Biopsy, Needle
Breast
Hyperplasia
Retrospective Studies
Risk Factors

Figure

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  Figure 1 Histopathologic features in core needle biopsy (CNB) and subsequent surgical excision. Foci of atypical ductal hyperplasia (ADH) were identified in CNB, and there were no stromal alterations around ducts showing ADH (A, H&E stain, ×400). In subsequent surgical excision specimens, there were 2 foci of ADH (B, H&E stain, ×200). In NCB, ADH foci were noted, and there was periductal fibroblast proliferation and fibrosis in periductal stroma (C, H&E stain, ×400). In subsequent surgical excision specimens, there was ductal carcinoma in situ showing periductal fibroblast proliferation, fibrosis, and inflammatory cell infiltration (D, H&E stain, ×200).

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