Can Some Patients With Atypical Ductal Hyperplasia Found at Stereotactic Vacuum-Assisted Breast Biopsy Avoid Surgical Excision?
) Objective: Prior research suggests that upgrade to ductal carcinoma in situ (DCIS) or invasive carcinoma does not occur when 11- or 14-gauge stereotactic breast biopsy reveals atypical ductal hyperplasia (ADH) in less than three ducts. Our goal was to determine if upgrade occurs in patients when stereotactic 9- or 11-gauge vacuum-assisted breast biopsy (VABB) yields ADH in less than three ducts and all mammographic calcifications are removed. Materials and Methods: Following IRB approval, we retrospectively reviewed 991 consecutive 9- or 11-gauge stereotactic VABB procedures from February, 2001 through June, 2006 to identify all cases performed for suspicious mammographic calcifications with a histologic diagnosis that included any type of atypia. Patients with a diagnosis of cancer at the time of biopsy or as a result of the biopsy were excluded. The search yielded 147 cases. A single pathologist performed a blinded review of and confirmed ADH in 112. Each large duct or terminal duc
