> Women who have a pre-cancerous diagnosis, such as atypical ductal hyperplasia
(cells that are abnormal in number, size, shape, growth pattern, and/or appearance) after a breast biopsy.
Those in which there was another finding that would prompt excision (atypical ductal hyperplasia
, flat epithelial atypia, papilloma, radial scar, DCIS, invasive carcinoma) were excluded and only those with available surgical excision results or at least 2 years of clinical and/or imaging follow-up were included.
Pathological examination with core-needle-biopsy (CNB) (4x14G) showed ductal hyperplasia
and diffuse hyperplastic tissue.
Proliferative lesions without atypia include ductal hyperplasia
of the usual type, sclerosing adenosis, radial scar, and intraductal papilloma.
(2) Several, non-malignant risk factors have been associated with an underlying occult breast cancer and, as a result, a core biopsy diagnosis of atypical ductal hyperplasia
, atypical lobular hyperplasia, radial scar formation, and intraductal papilloma have prompted an excisional biopsy.
Intraductal papilloma and generalized ductal hyperplasia
must also be considered in the differential diagnosis.
Low concordance in these studies was probably due to the inclusion of patients receiving chemotherapy and inclusion of cases diagnosed as atypical ductal hyperplasia
and in situ carcinomas in cytological samples.
These pathologies include: atypical ductal hyperplasia
(ADH), atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS) and atypical papillomas, all of which may present as cystic lesions in the breast.
Special techniques for example morphometry, DNA ploidy and immunohistochemical studies against various antigens are used to differentiate premalignant lesions like fibrocystic disease with epitheliosis, atypical ductal hyperplasia
, atypical lobular hyperplasia, sclerosing adenosis and carcinoma in situ.8
Lerwill, "Solid papillary ductal carcinoma in situ versus usual ductal hyperplasia
in the breast: a potentially difficult distinction resolved by cytokeratin 5/6," Human Pathology, vol.
Lehman, "Atypical ductal hyperplasia
on vacuum-assisted breast biopsy: suspicion for ductal carcinoma in situ can stratify patients at high risk for upgrade," Human Pathology, vol.
This is the first study outside the US to use the company's ForeCYTE device as well as its first sponsored study that will submit a subset of specimens (those from known carriers of the BRCA germline mutation) to contemporary molecular tests in addition to cytology (cellular evaluation of cells for evidence of ductal hyperplasia