ATYPICAL HYPERPLASIA - FREQUENCY AND MAMMOGRAPHIC AND PATHOLOGICAL RELATIONSHIPS IN EXCISIONAL BIOPSIES GUIDED WITH MAMMOGRAPHY AND CLINICAL EXAMINATION

PURPOSE: To ascertain the frequency and pathologic relationships of at ypical hyperplasia in biopsy specimens obtained after clinical and mam mographic examination. MATERIALS AND METHODS: Clinical, mammographic, and histologic findings were prospectively correlated in 300 consecuti ve excisional biopsies. RESULTS: Atypical hyperplasia was detected in 26 (17%) of 154 biopsies with benign findings and 19 (13%) of 146 biop sies with malignant findings overall (P > .05). The frequency of atypi cal hyperplasia was only 4% (two of 55 specimens) in clinically prompt ed biopsies with benign findings but 24% (24 of 99 specimens) in mammo graphically prompted biopsies with benign findings (P =.002), increasi ng to 31% (21 of 68 specimens) in benign microcalcifications and 40% ( 18 of 45 specimens) in benign microcalcifications associated with aden osis. Atypical hyperplasia was found most often within (16 [62%] of 26 cases) or adjacent to (nine [35%] of 26 cases) another lesion that pr ompted biopsy. CONCLUSION: Most atypical hyperplasia is not a random f inding in benign biopsy specimens but shows a statistically significan tly greater frequency in association with microcalcifications detected with mammography only, especially those in areas of adenosis.