Is bigger better? Twenty-year institutional experience of atypical ductal hyperplasia discovered by core needle biopsy

Jessica B. Weiss; Woo S. Do; Dominic M. Forte; Rowan R. Sheldon; Charles K. Childers; Vance Y. Sohn

doi:10.1016/j.amjsurg.2019.01.028

Is bigger better? Twenty-year institutional experience of atypical ductal hyperplasia discovered by core needle biopsy

Jessica B. Weiss^*, Woo S. Do, Dominic M. Forte, Rowan R. Sheldon, Charles K. Childers, Vance Y. Sohn

^*Corresponding author for this work

Surgery

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Objectives: The increasing accuracy of large-bore (11- or 8-gauge) vacuum-assisted core needle biopsies (VACNB) has challenged the commonly-accepted practice that surgery is needed for definitive diagnosis when atypical ductal hyperplasia (ADH) is found on VACNB. This study seeks to demonstrate the impact of increased VACNB caliber on the pathologic upgrade rate of ADH. Methods: Patients diagnosed with isolated ADH by VACNB who subsequently underwent surgical excision at our tertiary medical center were retrospectively studied. Demographics, needle gauge, number of needle passes, and pathology results were analyzed. Results: From June 1996 to June 2016, approximately 3740 VACNBs were performed. 139 patients were diagnosed with isolated ADH on VACNB and underwent surgical excision. 30 patients (22%) were upgraded to ductal carcinoma in-situ or invasive cancer; 17 upgrades (21%) from 11-gauge CNB vs. 13 upgrades (23%) from 8-gauge CNB (p = 0.67). Conclusion: Increasing core needle biopsy size from 11 g to 8 g does not decrease the rate of pathologic upstaging at the time of surgical excision. Surgical excision of ADH is still required for complete diagnosis.

Original language	English
Pages (from-to)	906-909
Number of pages	4
Journal	American Journal of Surgery
Volume	217
Issue number	5
DOIs	https://doi.org/10.1016/j.amjsurg.2019.01.028
State	Published - May 2019

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title = "Is bigger better? Twenty-year institutional experience of atypical ductal hyperplasia discovered by core needle biopsy",

abstract = "Objectives: The increasing accuracy of large-bore (11- or 8-gauge) vacuum-assisted core needle biopsies (VACNB) has challenged the commonly-accepted practice that surgery is needed for definitive diagnosis when atypical ductal hyperplasia (ADH) is found on VACNB. This study seeks to demonstrate the impact of increased VACNB caliber on the pathologic upgrade rate of ADH. Methods: Patients diagnosed with isolated ADH by VACNB who subsequently underwent surgical excision at our tertiary medical center were retrospectively studied. Demographics, needle gauge, number of needle passes, and pathology results were analyzed. Results: From June 1996 to June 2016, approximately 3740 VACNBs were performed. 139 patients were diagnosed with isolated ADH on VACNB and underwent surgical excision. 30 patients (22%) were upgraded to ductal carcinoma in-situ or invasive cancer; 17 upgrades (21%) from 11-gauge CNB vs. 13 upgrades (23%) from 8-gauge CNB (p = 0.67). Conclusion: Increasing core needle biopsy size from 11 g to 8 g does not decrease the rate of pathologic upstaging at the time of surgical excision. Surgical excision of ADH is still required for complete diagnosis.",

author = "Weiss, {Jessica B.} and Do, {Woo S.} and Forte, {Dominic M.} and Sheldon, {Rowan R.} and Childers, {Charles K.} and Sohn, {Vance Y.}",

note = "Publisher Copyright: {\textcopyright} 2019",

year = "2019",

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doi = "10.1016/j.amjsurg.2019.01.028",

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T1 - Is bigger better? Twenty-year institutional experience of atypical ductal hyperplasia discovered by core needle biopsy

AU - Weiss, Jessica B.

AU - Do, Woo S.

AU - Forte, Dominic M.

AU - Sheldon, Rowan R.

AU - Childers, Charles K.

AU - Sohn, Vance Y.

PY - 2019/5

Y1 - 2019/5

N2 - Objectives: The increasing accuracy of large-bore (11- or 8-gauge) vacuum-assisted core needle biopsies (VACNB) has challenged the commonly-accepted practice that surgery is needed for definitive diagnosis when atypical ductal hyperplasia (ADH) is found on VACNB. This study seeks to demonstrate the impact of increased VACNB caliber on the pathologic upgrade rate of ADH. Methods: Patients diagnosed with isolated ADH by VACNB who subsequently underwent surgical excision at our tertiary medical center were retrospectively studied. Demographics, needle gauge, number of needle passes, and pathology results were analyzed. Results: From June 1996 to June 2016, approximately 3740 VACNBs were performed. 139 patients were diagnosed with isolated ADH on VACNB and underwent surgical excision. 30 patients (22%) were upgraded to ductal carcinoma in-situ or invasive cancer; 17 upgrades (21%) from 11-gauge CNB vs. 13 upgrades (23%) from 8-gauge CNB (p = 0.67). Conclusion: Increasing core needle biopsy size from 11 g to 8 g does not decrease the rate of pathologic upstaging at the time of surgical excision. Surgical excision of ADH is still required for complete diagnosis.

AB - Objectives: The increasing accuracy of large-bore (11- or 8-gauge) vacuum-assisted core needle biopsies (VACNB) has challenged the commonly-accepted practice that surgery is needed for definitive diagnosis when atypical ductal hyperplasia (ADH) is found on VACNB. This study seeks to demonstrate the impact of increased VACNB caliber on the pathologic upgrade rate of ADH. Methods: Patients diagnosed with isolated ADH by VACNB who subsequently underwent surgical excision at our tertiary medical center were retrospectively studied. Demographics, needle gauge, number of needle passes, and pathology results were analyzed. Results: From June 1996 to June 2016, approximately 3740 VACNBs were performed. 139 patients were diagnosed with isolated ADH on VACNB and underwent surgical excision. 30 patients (22%) were upgraded to ductal carcinoma in-situ or invasive cancer; 17 upgrades (21%) from 11-gauge CNB vs. 13 upgrades (23%) from 8-gauge CNB (p = 0.67). Conclusion: Increasing core needle biopsy size from 11 g to 8 g does not decrease the rate of pathologic upstaging at the time of surgical excision. Surgical excision of ADH is still required for complete diagnosis.

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JO - American Journal of Surgery

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IS - 5

ER -

Is bigger better? Twenty-year institutional experience of atypical ductal hyperplasia discovered by core needle biopsy

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