Factors in the Breast Core Needle Biopsies of Atypical Ductal Hyperplasia that Can Predict Carcinoma in the Subsequent Surgical Excision Specimens

Purpose: Our purpose was to identify the factors in a breast core needle biopsy (CNB) of atypical ductal hyperplasia (ADH) that are predictive for carcinoma in the subsequent excision specimens. Methods: We performed a retrospective pathologic review of 50 cases that were diagnosed as ADH via the CNB and that had the corresponding excision specimens. Results: The size of the largest ADH foci in the CNBs was 0.8 +/- 0.6 mm (mean SD) for benign proliferative disease (BPD, n=12), 1.0 +/- 0.5 mm (mean +/- SD) for ADH (n=9) and 1.3 +/- 0.8 nnm (mean +/- SD) for malignant lesions (n=29) in excision specimens (p=0.105). Among the 30 cases showing stromal alterations around the ducts with ADH in the CNBs, 9 cases (30.0%) were BPD or ADH and 21 cases (70.0%) were malignant lesions in the excision specimens (p=0.004). Conclusion: As the stromal alterations around the ADH were noted in the CNB, there was an increased likelihood that more advanced lesions would be identified in the surgical excision specimens.