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Does atypical ductal hyperplasia require 6 months of postoperative surveillance?

Publication ,  Conference
Plichta, JK; Rumas, N; Godellas, CV; Perez, CB
Published in: Journal of Clinical Oncology
September 20, 2012

60 Background: Standard follow-up imaging for women with a history of breast cancer is well defined, but the appropriate screening guidelines for other high risk breast lesions, such as atypical ductal hyperplasia (ADH), remain unclear. Current practices often parallel those of cancer patients and include a 6 month interval mammogram prior to resuming annual screening, which may be unnecessary. As such, it is critical to evaluate the utility of the current standard practice of additional screening beyond a routine annual mammogram. Methods: Our pathology database was queried for the phrase "atypical ductal hyperplasia" from 2008 to 2010, and patients who underwent surgical excision were identified. Those who did not have subsequent follow up at our institution were excluded. Results: There were 44 patients who underwent excisional biopsies that were diagnosed with ADH and proceeded with follow up. In addition to a routine clinical exam, a short-term follow up diagnostic mammogram was performed in 24 patients. The median age was 56.5 years, and the median breast cancer risk assessment scores were 2.8% at 5 years and 13.4% lifetime. Of the 24 interval mammograms, 21 yielded benign findings on initial imaging (BIRADS 2), while 3 patients (12.5%) required additional imaging that ultimately resulted in benign findings. There were only 4 patients with a lifetime risk ≥25%, and all of these patients had benign findings on their initial imaging and resumed routine follow up. To date, 22 patients have received at least one additional mammogram, and all subsequent findings have been benign. No additional biopsies or surgeries have been performed. Conclusions: In sum, a clinical exam is still recommended at 6 months following surgical excision for a diagnosis of ADH. In the post-surgical breast, imaging may be misleading and result in psychological distress for patients and possibly unnecessary procedures. Based on our findings, a 6-month follow up mammogram is not recommended and patients should resume annual surveillance.

Duke Scholars

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

September 20, 2012

Volume

30

Issue

27_suppl

Start / End Page

60 / 60

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Plichta, J. K., Rumas, N., Godellas, C. V., & Perez, C. B. (2012). Does atypical ductal hyperplasia require 6 months of postoperative surveillance? In Journal of Clinical Oncology (Vol. 30, pp. 60–60). American Society of Clinical Oncology (ASCO). https://doi.org/10.1200/jco.2012.30.27_suppl.60
Plichta, Jennifer Kay, Natalia Rumas, Constantine V. Godellas, and Claudia Beth Perez. “Does atypical ductal hyperplasia require 6 months of postoperative surveillance?” In Journal of Clinical Oncology, 30:60–60. American Society of Clinical Oncology (ASCO), 2012. https://doi.org/10.1200/jco.2012.30.27_suppl.60.
Plichta JK, Rumas N, Godellas CV, Perez CB. Does atypical ductal hyperplasia require 6 months of postoperative surveillance? In: Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2012. p. 60–60.
Plichta, Jennifer Kay, et al. “Does atypical ductal hyperplasia require 6 months of postoperative surveillance?Journal of Clinical Oncology, vol. 30, no. 27_suppl, American Society of Clinical Oncology (ASCO), 2012, pp. 60–60. Crossref, doi:10.1200/jco.2012.30.27_suppl.60.
Plichta JK, Rumas N, Godellas CV, Perez CB. Does atypical ductal hyperplasia require 6 months of postoperative surveillance? Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2012. p. 60–60.

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

September 20, 2012

Volume

30

Issue

27_suppl

Start / End Page

60 / 60

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences