Can mammographic findings help discriminate between atypical ductal hyperplasia and ductal carcinoma in situ after needle core biopsy?

Jenny K. Hoang, Prue Hill and Jennifer N. Cawson
The Breast 17, Issue 3, June 2008, Pages 282-288

Link to Journal

In a screening population of women, the mammographic characteristics for 68 cases of atypical ductal hyperplasia (ADH) diagnosed by needle core biopsy (NCB) were reviewed to seek mammographic findings which differentiate between ductal carcinoma in situ (DCIS) and ADH. A blinded analysis by two radiologists was performed for 48 cases with microcalcification. The mammographic findings were correlated with the surgical histological results of benign non-atypical, ADH and carcinoma (DCIS or invasive) to identify features which were associated with a higher or lower odds ratio (OR) for malignancy. Underestimates for malignancy occurred in 14 of 29 cases with granular calcification form (OR 7.9, 95% confidence interval (CI) 1.5–41) and 6 of 8 cases with segmental/linear branching distribution (OR 9.0, 95%CI 1.6–52). No malignancy was found at surgical excision in 16 cases with fine, rounded calcification.

In conclusion, detailed assessment of calcification distribution and form gave helpful predictors for malignancy. Lesions with fine rounded calcification were always benign.

Atypical ductal hyperplasia: A way to minimize underestimation in vacuum-assisted breast biopsy?

Flora Zagouri, Theodoros N. Sergentanis, Dimitra Koulocheri, Aphrodite Nonni, John Bramis and George C. Zografos
The Breast Volume 17, Issue 1, February 2008, Page 6
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WC2-4RV5S14-1&_user=4430&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000059594&_version=1&_urlVersion=0&_userid=4430&md5=cbdb6cda71a63b774631bde5c69d6618

The underestimation rate of atypical ductal hyperplasia (ADH) diagnosed via vacuum-assisted breast biopsy (VABB) is a crucial issue in the common clinical practice. Bedei et al. examined the underestimation of ADH diagnosis by VABB.
Independently, our research team has evaluated putative ways of minimizing underestimation rate in pre-invasive breast lesions.