Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: Improved reliability with 14-gauge, directional, vacuum-assisted biopsy

Roger J. Jackman, Fred Burbank, Steve H. Parker, W. Phil Evans, Mary C. Lechner, Thomas R. Richardson, Irena Tocino, Alan B. Wray

Research output: Contribution to journalArticle

254 Scopus citations

Abstract

PURPOSE: To compare histologic findings of atypical ductal hyperplasia (ADH) at 14-gauge, directional, vacuum-assisted breast biopsy (hereafter, vacuum-assisted biopsy) and at 14-gauge, automated, large-core breast biopsy (hereafter, large-core biopsy) with findings at histologic examination after surgical biopsy. MATERIALS AND METHODS: Nonpalpable breast lesions were diagnosed as ADH at histologic examination after vacuum-assisted biopsy in 88 lesions in seven institutions and after large-core biopsy in 55 previously reported lesions. Histologic findings at subsequent surgical biopsy were compared for the presence of carcinoma. RESULTS: On the basis of histologic findings of carcinoma at surgical biopsy, the diagnosis of ADH was not correct in 26 (48%) of 54 lesions sampled at large-core biopsy and in 13 (18%) of 74 lesions sampled at vacuum-assisted biopsy (Fisher exact test, P < .0004). More tissue specimens were obtained at vacuum-assisted biopsy (mean, 15.8 specimens) than at large-core biopsy (mean, 9.7 specimens). Individual specimens were twice as large at vacuum-assisted biopsy (mean, 34 mg) as at large-core biopsy (mean, 17 mg) (previously reported). CONCLUSION: ADH was diagnosed 2.7 times more reliably at vacuum-assisted biopsy than at large- core biopsy (with no increase in complications) with most of the improvement as a result of acquisition of more than 10 specimens per lesion, but carcinoma was sufficiently underestimated with both methods to necessitate surgical biopsy.

Original languageEnglish (US)
Pages (from-to)485-488
Number of pages4
JournalRadiology
Volume204
Issue number2
Publication statusPublished - Aug 1997

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Keywords

  • Biopsies, technology
  • Breast neoplasms, diagnosis
  • Breast, biopsy
  • Breast, diseases

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Jackman, R. J., Burbank, F., Parker, S. H., Evans, W. P., Lechner, M. C., Richardson, T. R., ... Wray, A. B. (1997). Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: Improved reliability with 14-gauge, directional, vacuum-assisted biopsy. Radiology, 204(2), 485-488.