Fahad Azzumeea, Presenter: Nothing to Disclose

Runi Chattopadhyay, Abstract Co-Author: Nothing to Disclose

Mona Michel El Khoury MD, Abstract Co-Author: Nothing to Disclose

Sarkis Meterissian, Abstract Co-Author: Nothing to Disclose

Attila Omeroglu, Abstract Co-Author: Nothing to Disclose

Benoit Delphin Mesurolle MD, Abstract Co-Author: Nothing to Disclose

(1) Do describe the sonographic and mammographic features of lesions diagnosed as Atypical Ductal Hyperplasia (ADH) after sonographic guided biopsy. (2) To determine the value of a sonographic guided biopsy yielding ADH.

Retrospective review was performed of 1988 consecutive sonographic guided biopsies (14 Gauge). Percutaneous biopsy yielded ADH in 30 lesions (1.5%). Subsequent surgical biopsy was performed in 29 lesions in 29 patients. Histologic results of core and surgical biopsy were compared. A retrospective combined consensus review of the available 28 mammograms and 30 breast sonograms was performed by two radiologists following the BI-RADS Lexicon.

Surgical biopsy confirmed the diagnosis of ADH in 6 patients(21%), revealed carcinoma in 14 patients(48%, 10 ductal carcinoma in situ and 4 invasive carcinoma), and benign/lower risk lesions in 9 patients(31%). Mammograms were normal (16/28, 57%) or showed a nonspecific mass (6/28, 21 %). Sonographically, these lesions were hypoechoic (21/30, 70%), irregular shaped (18/30, 60%) with microlobulated margins (20/30, 67%), abrupt interfaces (25/30, 83%) and parallel orientation (21/30, 70%) without posterior acoustic features (11/30, 37%). The pure ADH proven lesions after surgical biopsy, were oval (3/6, 50%) or irregular shaped (3/6, 50%), with microlobulated margins (4/6, 66%) and parallel orientation (6/6, 100%).

ADH diagnosed by sonographic guided core needle biopsy was underestimated in 48% of the lesions indicating surgical excision systematically. The sonographic appearance of ADH lesions diagnosed with sonographic guided biopsy is nonspecific and may lack malignant characteristics.

Surgical excision is warranted in lesions in which ADH is found at sonographic guided core biopsy

Azzumeea, F, Chattopadhyay, R, El Khoury, M, Meterissian, S, Omeroglu, A, Mesurolle, B, Atypical Ductal Hyperplasia Diagnosed at Sonographic-guided Core Needle Biopsy: Sonographic and Mammographic Appearance and Surgical Biopsy Findings.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005801.html