ArticleDiagnostic pathology2019
Diagnostic terminology used to describe atypia on breast core needle biopsy: correlation with excision and upgrade rates.
Article in Diagnostic pathology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- High-Risk Benign Breast Lesions: An Ontario Health (Cancer Care Ontario) Recommendations Report.Current oncology (Toronto, Ont.) · 2026Review
- Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions).Virchows Archiv : an international journal of pathology · 2023Review
- [B3 lesions of the breast: histological, clinical, and epidemiological aspects : Update].Pathologie (Heidelberg, Germany) · 2023Review
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSubjective qualitative descriptors are sometimes used to describe atypical breast lesions diagnosed on core needle biopsy (CNB) which are limited in extent. In clinical practice, this terminology is used to imply a lower expected risk of upgrade on surgical excision (EXC). It is uncertain how subjective terminology impacts clinical management.
methodsWe conducted a retrospective review of CNB with atypia and compared the EXC and upgrade rates of atypical ductal hyperplasia (ADH) and flat epithelial atypia (FEA) to lesions described as "focal" atypical ductal hyperplasia (FADH), to determine the impact of this diagnostic phrasing on surgical management and risk of malignancy.
resultsFADH and ADH were excised at similar rates (82% vs. 78%). FADH lesions showed a similar upgrade rate (13%) compared to non-focal ADH (10%), and both showed a trend towards higher upgrade and EXC rates compared to FEA. ADH, FADH and FEA all had an upgrade risk that warranted EXC. In non-upgraded EXC, for each diagnostic category we observed similar rates of residual atypia in the EXC.
conclusionsPathologists should avoid the use of qualitative descriptors when describing ADH on CNB because of the potential of this terminology to influence clinical decision making which is unwarranted.
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