Upgrade rate of core biopsy-determined atypical ductal hyperplasia by open excisional biopsy

Suspicious Findings in Reduction Mammaplasty Specimens: Review of 182 Consecutive Patients

“…Recent literature recommends that atypical ductal hyperplasia found on stereotactic breast biopsy for a mammographic abnormality should be followed by wider excisional biopsy as a result of a high upgrade rate, 9 with a reported rate of subsequent breast carcinoma detection as high as 47% after wider biopsy. 10 In this situation, the mammographic abnormalities presumably represent areas of carcinoma or carcinoma in situ, and the areas of atypical ductal hyperplasia are adjacent tissue samples that cause underdiagnosis by tissue sampling error.…”

Intraoperative Ultrasonographically Guided Excisional Biopsy or Vacuum-Assisted Core Needle Biopsy for Nonpalpable Breast Lesions

“…Five core samples are routinely obtained using LCNB or mammotome biopsy, and a certain number of reexcisional biopsies are needed to eliminate underestimates and false-negative results. 11,26,27 Liberman et al have reported that infiltrating ductal carcinoma may be completely excised if 14 or more core samples are obtained, 28 and Parker et al have suggested that 9 core samples can entirely remove a breast mass Ͻ1.5 cm. 18 In our study, the average number of tissue samplings per lesion was 16 in cases of complete excision, with an average duration of 28 minutes.…”

Nomogram to predict the likelihood of upgrade of atypical ductal hyperplasia diagnosed on a core needle biopsy in mammographically detected lesions

“…Later, the focus shifted to improving the diagnosis of ADH and lowering the rates of underdiagnosis . With stricter adherence to established criteria and improved technology, intraobserver variability and rates of underdiagnosis of ADH on the core biopsy sample have generally decreased …”

“…Continued focus remains on the upgrade of ADH diagnosed on core biopsy to a more malignant lesion of either ductal carcinoma in situ (DCIS) or invasive carcinoma on excisional biopsy. It is becoming increasingly clear that while ADH on core biopsy portends an increased risk for a more malignant lesion on surgical excision, not all cases of ADH result in a significant upgrade on surgical excision . Subsets of these cases are due to variability in histological interpretation and sampling of the lesion in question.…”