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J Breast Cancer. 2012 Dec;15(4):407-11. doi: 10.4048/jbc.2012.15.4.407. Epub 2012 Dec 31.

Validation of a scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia using an ultrasound-guided core needle biopsy.

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  • 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE:

The need for surgical excision in patients with ultrasound-guided core needle biopsy (CNB)-diagnosed atypical ductal hyperplasia (ADH) remains an issue of debate. The present study sought to validate a scoring system (the U score, for underestimation) that we have previously developed for predicting malignancy in CNB-diagnosed ADH.

METHODS:

The study prospectively enrolled 85 female patients with CNB-diagnosed ADH who underwent subsequent surgical excision. Underestimation was defined as a surgical specimen having malignant foci.

RESULTS:

The overall underestimation rate was 37% (31/85). Multivariate analysis showed that a clinically palpable mass, microcalcification on imaging, size >15 mm and a patient age of ≥50 years were independently associated with underestimation. When applied to the scoring system, the validation score was significant (p<0.001; area under the curve, 0.852). No patient with a U score <3.5 had an underestimated lesion.

CONCLUSION:

The present study successfully validated the efficacy of our scoring system for predicting malignancy in CNB-diagnosed ADH. A U score of ≤3.5 indicates that surgical excision may not be necessary.

KEYWORDS:

Breast hyperplasia; Breast neoplasms; Diagnostic errors; Needle biopsy

PMID:
23346169
[PubMed]
PMCID:
PMC3542848
Free PMC Article
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