Predicting cancer on excision of atypical ductal hyperplasia

Atypical ductal hyperplasia on vacuum-assisted breast biopsy: suspicion for ductal carcinoma in situ can stratify patients at high risk for upgrade☆

“…Other studies have associated the presence of a micropapillary growth pattern of ADH on core biopsy with upgrade rates to DCIS on excision [13,30,32]. The studies by Ely et al and Wagoner et al both found a strong association between micropapillary ADH on core biopsy with upgrade to cancer, whereas Doren et al and our current study did not find a significant association with upgrade.…”

“…Additional smaller studies have associated the reported degree of "severity" of histologic features of ADH as a predictor of carcinoma on excision report similar findings [13,[33][34][35]. Most of these studies have attempted to classify the severity of ADH on core biopsy using a 3-tiered system of "mild," "moderate," and "marked atypia" [13,33,34].…”

“…The mean number of cores obtained per case was 9.8 (range, [6][7][8][9][10][11][12][13][14][15][16][17][18]. The number of foci of ADH and classification as suspicious for DCIS were both significantly associated with upgrade rates but size of the largest focus was not (See Table 1).…”

“…Most of these studies have attempted to classify the severity of ADH on core biopsy using a 3-tiered system of "mild," "moderate," and "marked atypia" [13,33,34]. These studies all had upgrade rates in the "marked atypia" category ranging from 75% to 80%.…”

Femmes à risque

“…Les essais de prévention du tamoxifène ont montré une réduction de 38 % (IC 95 % : [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] ; p < 0,0001) de l'incidence des CS. Il n'y avait pas d'efp < 0,0001) de l'incidence des CS.…”