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Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle.

Publication ,  Journal Article
Sohn, V; Arthurs, Z; Herbert, G; Keylock, J; Perry, J; Eckert, M; Fellabaum, D; Smith, D; Brown, T
Published in: Ann Surg Oncol
September 2007

BACKGROUND: Percutaneous stereotactic core needle biopsy (CNB) has become the primary diagnostic modality for evaluating nonpalpable, mammographically detected breast lesions. Atypical ductal hyperplasia (ADH) uncovered by CNB confers a significant risk of harboring an occult malignancy in the excisional biopsy specimen; therefore, we sought to determine the benefits of upsizing biopsy needles from 14- to 11-gauge. METHODS: Patients with isolated ADH diagnosed by CNB were included for analysis in this retrospective review. Mammographic description, number of needle passes, pathology results, and follow-up data were analyzed and compared to our previously published institutional results with the 14-gauge needle. RESULTS: From June 1996 until July 2006, 4,579 CNBs were performed at our tertiary level medical facility. Seventy eight of 88 patients (89%) diagnosed with ADH on CNB with an 11-gauge vacuum-assisted needle underwent open surgical excision. Of these patients, nine (11%) were upgraded to ductal carcinoma in-situ (DCIS) while five (6%) had invasive cancer (IC), giving a total underestimation rate of 17%. These results differ from our previously published series of 14-gauge CNB which revealed an underestimation rate of 36%. Mean number of passes obtained at time of biopsy, mean age of patients, and characteristic radiographic abnormalities were similar for malignant and benign diagnoses. CONCLUSION: 11-gauge CNB technique reduces sampling error and improves accuracy, but does not eliminate the risk of missing an underlying malignancy. Surgical excision of ADH identified by CNB is required for definitive diagnosis.

Duke Scholars

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

September 2007

Volume

14

Issue

9

Start / End Page

2497 / 2501

Location

United States

Related Subject Headings

  • Vacuum
  • Retrospective Studies
  • Precancerous Conditions
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Mammography
  • Hyperplasia
  • Humans
  • Female
 

Citation

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Chicago
ICMJE
MLA
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Sohn, V., Arthurs, Z., Herbert, G., Keylock, J., Perry, J., Eckert, M., … Brown, T. (2007). Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle. Ann Surg Oncol, 14(9), 2497–2501. https://doi.org/10.1245/s10434-007-9454-0
Sohn, Vance, Zachary Arthurs, Garth Herbert, Joren Keylock, Jason Perry, Matthew Eckert, Dean Fellabaum, Donald Smith, and Tommy Brown. “Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle.Ann Surg Oncol 14, no. 9 (September 2007): 2497–2501. https://doi.org/10.1245/s10434-007-9454-0.
Sohn V, Arthurs Z, Herbert G, Keylock J, Perry J, Eckert M, et al. Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle. Ann Surg Oncol. 2007 Sep;14(9):2497–501.
Sohn, Vance, et al. “Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle.Ann Surg Oncol, vol. 14, no. 9, Sept. 2007, pp. 2497–501. Pubmed, doi:10.1245/s10434-007-9454-0.
Sohn V, Arthurs Z, Herbert G, Keylock J, Perry J, Eckert M, Fellabaum D, Smith D, Brown T. Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle. Ann Surg Oncol. 2007 Sep;14(9):2497–2501.
Journal cover image

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

September 2007

Volume

14

Issue

9

Start / End Page

2497 / 2501

Location

United States

Related Subject Headings

  • Vacuum
  • Retrospective Studies
  • Precancerous Conditions
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Mammography
  • Hyperplasia
  • Humans
  • Female