Active Surveillance of Atypical Ductal Hyperplasia of the Breast

When needle core biopsy (NCB) of the breast yields atypical ductal hyperplasia (ADH), excision is typically recommended. The natural history of ADH undergoing active surveillance (AS) is not well described. We investigate the rates of upgrade to malignancy of excised ADH and the rates of radiographi...

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Bibliographic Details
Published in:Clinical breast cancer 2023-08, Vol.23 (6), p.649-657
Main Authors: Han, Lynn K., Hussain, Anum, Dodelzon, Katerina, Ginter, Paula S., Towne, William S., Marti, Jennifer L.
Format: Article
Language:English
Subjects:
ADH
Benign
Biopsy, Large-Core Needle
Breast - diagnostic imaging
Breast - pathology
Breast - surgery
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Carcinoma, Intraductal, Noninfiltrating - diagnostic imaging
Carcinoma, Intraductal, Noninfiltrating - pathology
Carcinoma, Intraductal, Noninfiltrating - surgery
Female
High risk breast lesion
Humans
Hyperplasia - diagnostic imaging
Hyperplasia - pathology
Hyperplasia - surgery
Prospective Studies
Retrospective Studies
Surveillance
Watchful Waiting
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Summary:When needle core biopsy (NCB) of the breast yields atypical ductal hyperplasia (ADH), excision is typically recommended. The natural history of ADH undergoing active surveillance (AS) is not well described. We investigate the rates of upgrade to malignancy of excised ADH and the rates of radiographic progression under AS. We retrospectively reviewed records of 220 cases of ADH on NCB. Of patients who had surgery within 6 months of NCB, we examined the malignancy upgrade rate. In the AS cohort, we examined rates of radiographic progression on interval imaging. The malignancy upgrade rate among patients who underwent immediate excision (n = 185) was 15.7%: 14.1% (n = 26) ductal carcinoma in situ (DCIS) and 1.6% (n = 3) invasive ductal carcinoma (IDC). Upgrade to malignancy was less common in lesions
ISSN:1526-8209
1938-0666
DOI:10.1016/j.clbc.2023.05.008