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Article

Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?

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Department of Breast Radiology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy
2
Department of Emergency and Organ Transplantation, Section of Anatomic Pathology, School of Medicine, University “Aldo Moro”, 70124 Bari, Italy
3
Postgraduate School in Radiology, University of Milan, 20122 Milan, Italy
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Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy
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Division of Pathology and Laboratory Medicine, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy
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Division of Cancer Prevention and Genetics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
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Division of Breast Surgery, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Gustavo Baldassarre
Diagnostics 2021, 11(6), 1120; https://doi.org/10.3390/diagnostics11061120
Received: 2 May 2021 / Revised: 16 June 2021 / Accepted: 17 June 2021 / Published: 19 June 2021
(This article belongs to the Special Issue Challenging Topics in Breast Cancer Diagnosis and Treatment)
(1) Background: to evaluate which factors can reduce the upgrade rate of atypical ductal hyperplasia (ADH) to in situ or invasive carcinoma in patients who underwent vacuum-assisted breast biopsy (VABB) and subsequent surgical excision. (2) Methods: 2955 VABBs were reviewed; 141 patients with a diagnosis of ADH were selected for subsequent surgical excision. The association between patients’ characteristics and the upgrade rate to breast cancer was evaluated in both univariate and multivariate analyses. (3) Results: the upgrade rates to ductal carcinoma in situ (DCIS) and invasive carcinoma (IC) were, respectively, 29.1% and 7.8%. The pooled upgrade rate to DCIS or IC was statistically lower at univariate analysis, considering the following parameters: complete removal of the lesion (p-value < 0.001); BIRADS ≤ 4a (p-value < 0.001); size of the lesion ≤15 mm (p-value: 0.002); age of the patients <50 years (p-value: 0.035). (4) Conclusions: the overall upgrade rate of ADH to DCIS or IC is high and, as already known, surgery should be recommended. However, ADH cases should always be discussed in multidisciplinary meetings: some parameters appear to be related to a lower upgrade rate. Patients presenting these parameters could be strictly followed up to avoid overtreatment. View Full-Text
Keywords: breast biopsy; BIRADS; atypical duct hyperplasia; breast surgery; breast cancer; upgrade to cancer; overtreatment breast biopsy; BIRADS; atypical duct hyperplasia; breast surgery; breast cancer; upgrade to cancer; overtreatment
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MDPI and ACS Style

Nicosia, L.; Latronico, A.; Addante, F.; De Santis, R.; Bozzini, A.C.; Montesano, M.; Frassoni, S.; Bagnardi, V.; Mazzarol, G.; Pala, O.; Lazzeroni, M.; Lissidini, G.; Mastropasqua, M.G.; Cassano, E. Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate? Diagnostics 2021, 11, 1120. https://doi.org/10.3390/diagnostics11061120

AMA Style

Nicosia L, Latronico A, Addante F, De Santis R, Bozzini AC, Montesano M, Frassoni S, Bagnardi V, Mazzarol G, Pala O, Lazzeroni M, Lissidini G, Mastropasqua MG, Cassano E. Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate? Diagnostics. 2021; 11(6):1120. https://doi.org/10.3390/diagnostics11061120

Chicago/Turabian Style

Nicosia, Luca, Antuono Latronico, Francesca Addante, Rossella De Santis, Anna Carla Bozzini, Marta Montesano, Samuele Frassoni, Vincenzo Bagnardi, Giovanni Mazzarol, Oriana Pala, Matteo Lazzeroni, Germana Lissidini, Mauro Giuseppe Mastropasqua, and Enrico Cassano. 2021. "Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?" Diagnostics 11, no. 6: 1120. https://doi.org/10.3390/diagnostics11061120

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