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Management of patients diagnosed with atypical ductal hyperplasia by vacuum-assisted core biopsy: a prospective assessment of the guidelines used at our institution

Authors :
Youenn Drouet
Catherine Chassagne-Clément
Nicole Guerin
Isabelle Treilleux
Mathilde Peyron
Alizée Caplain
Frédéric Beurrier
Christine Lasset
Marie Peix
Marie-Eve Fondrevelle
Christelle Faure
Source :
The American Journal of Surgery. 208:260-267
Publication Year :
2014
Publisher :
Elsevier BV, 2014.

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.

Details

ISSN :
00029610
Volume :
208
Database :
OpenAIRE
Journal :
The American Journal of Surgery
Accession number :
edsair.doi.dedup.....d3570c1876d0f7b346f610e11a0d0622
Full Text :
https://doi.org/10.1016/j.amjsurg.2013.10.029