Upgrade rate of core biopsy-determined atypical ductal hyperplasia by openexcisional biopsy

Background: Core biopsy Ending of atypical ductal hyperplasia (ADH) are gen erally followed by open biopsy to avoid underestimation of malignant diseas e. Methods: Retrospective examination of I I gauge stereotactic-guided vacuum- assisted core biopsies was made with respect to ADH diagnosis, follow-up op en biopsy, and upgrade rate. Readily available clinical, mammographic, and pathologic features potentially contributory to an upgrade were studied. Results: This series of 1,313 patients had 43 ADH diagnoses. Thirty-two had open follow-up. There were 4 upgrades. Mammographic indication for biopsy, age, removal of calcifications, and the percentage of ADH in the specimen were not significant in predicting an upgrade with all probabilities over 0 .10, odds ratios not different than 1, and 95% bounds all encompassing 1. Conclusions: These data indicate a high upgrade rate (13%) for ADH-positive core biopsies with no definitive predictive criteria for an upgrade. Our d ata support follow-up excision of ADH lesions diagnosed by core biopsy. (C) 2001 Excerpta Medica, Inc. All rights reserved.