Evidence map›Paper›PMID 40908450›Full record

ArticleAnnals of surgical oncology2026

Implications of the COMET Trial for the Management of Atypical Ductal Hyperplasia.

Shruti Zaveri, Susie X Sun, Therese B Bevers, Constance T Albarracin, Isabelle Bedrosian

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Active Monitoring versus Surgical Excision for Atypical Ductal Hyperplasia.Cancer prevention research (Philadelphia, Pa.) · 2026
    Observational
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shruti ZaveriDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Susie X SunDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Therese B BeversDepartment of Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Constance T AlbarracinDepartment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Isabelle BedrosianDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. ibedrosian@mdanderson.org.ORCID http://orcid.org/0000-0002-8775-8361

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe recently reported results from the COMET trial investigating the nonoperative management of low-risk ductal carcinoma in situ (DCIS) question the need for routine excision of atypical ductal hyperplasia (ADH). This study aimed to examine the upgrade rates of patients with ADH who met applicable COMET trial criteria.

methodsCases of ADH managed with surgery at our institution between 2004 and 2022 were identified, and clinical variables were extracted from the medical record. Rates of ADH upgrade to in situ and invasive disease were compared between patients who met the selected COMET criteria for age, imaging findings, and personal history of breast cancer and those who did not.

resultsOf the 362 ADH cases that met the inclusion criteria for this study; 233 (64.4 %) met the selective COMET criteria (cohort 1) and 129 (35.6 %) did not (cohort 2). The two cohorts did not differ significantly in terms of age, race, breast density, or size of lesion on imaging. The cohort 1 patients were more likely to have their diagnosis determined by mammography (94 % vs 72 %; p < 0.01) and more likely to present with calcifications (82 % vs 30.2 %; p < 0.01). The rate of upgrade to DCIS did not differ significantly between the cohorts, but the rate of invasive disease was significantly lower in cohort 1 (3.43 % vs 10.85 %; p < 0.01).

conclusionThe study data showed a very low rate of ADH upgrade to invasive disease for the patients who met the COMET criteria for age, imaging findings, and breast cancer history, suggesting that such patients also could be considered a low-risk cohort for whom observation might be appropriate.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, Intraductal, NoninfiltratingAdultAgedFemaleFollow-Up StudiesHumansHyperplasiaMammographyMiddle AgedPrognosisRetrospective StudiesADHCOMET trialObservationSurgeryUpgrade

Identifiers

PMID40908450

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.