1. Management of patients diagnosed with atypical ductal hyperplasia by vacuum-assisted core biopsy: a prospective assessment of the guidelines used at our institution
- Author
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Youenn Drouet, Catherine Chassagne-Clément, Nicole Guerin, Isabelle Treilleux, Mathilde Peyron, Alizée Caplain, Frédéric Beurrier, Christine Lasset, Marie Peix, Marie-Eve Fondrevelle, and Christelle Faure
- Subjects
Adult ,medicine.medical_specialty ,Vacuum ,Both breasts ,Vacuum assisted ,Breast Neoplasms ,Humans ,Medicine ,Ductal Hyperplasia ,Mammary Glands, Human ,Prospective cohort study ,Ultrasonography, Interventional ,Aged ,Aged, 80 and over ,Hyperplasia ,business.industry ,Biopsy, Needle ,Calcinosis ,Cancer ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Practice Guidelines as Topic ,Female ,Surgical excision ,Ultrasonography, Mammary ,business ,Core biopsy ,Precancerous Conditions ,Carcinoma in Situ - Abstract
Because of underestimation, surgical excision is recommended for atypical ductal hyperplasia diagnosed on directional vacuum-assisted biopsies. The following guidelines have been established according to our retrospective study published in 2008: excision for lesions ≥ 21 mm, follow-up for lesions6 mm with complete removal of microcalcifications, and follow-up or excision for 6 to 21-mm lesions with respectively less or2 atypical ductal hyperplasia foci.These guidelines were assessed in a prospective series of 124 patients with a median follow-up of 30 months. Conformity rate was 92%. Upgrading was 28% (15 of 53 patients) for conformed surgery and absent for surgery performed beyond the scope of guidelines. For the patients with benign result at surgery (n = 38) or just followed (n = 61), 3 cancers occurred in either breast at 1 to 3 years.These convenient guidelines can safely spare surgery for a subset of patients. However, annual mammographic follow-up is recommended since the risk of subsequent cancer remains high for both breasts.
- Published
- 2014
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