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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
- 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.
- 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
Subjects
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