ATYPICAL HYPERPLASIA IN THE ERA OF STEREOTAXIC CORE NEEDLE-BIOPSY

Background and Objectives: To characterize both atypical hyperplasia ( AH) and the malignancies typically present at open surgical biopsy in women diagnosed with AH by stereotactic core needle biopsy (SCNB). Met hods: Patients with AH diagnosed by SCNB were advised to undergo surgi cal biopsy to rule out an associated malignancy. Mammography findings, pathology reports and follow-up data were analyzed. Results: AH was i dentified by SCNB in 38 of 893 (4.3%) patients. Carcinoma was identifi ed in 12 of 33 (36.4%) patients who went on to surgical biopsy. Ductal carcinoma in situ (DCIS) was present in 11 of the 12 patients with ma lignancy. There were no characteristic mammographic findings which wou ld identify patients with carcinoma. Conclusions: When SCNB returns a diagnosis of AH there is a substantial risk of an associated malignanc y in the breast. There appear to be no definitive criteria to distingu ish which patients harbor a malignancy, and surgical biopsy should alw ays serve as an adjunct diagnostic procedure. (C) 1998 Wiley-Liss, Inc .