Validation of a Scoring System for Predicting Malignancy in Patients Diagnosed with Atypical Ductal Hyperplasia Using an Ultrasound-Guided Core Needle Biopsy.
10.4048/jbc.2012.15.4.407
- Author:
Jisun KIM
1
;
Wonshik HAN
;
Eun Young GO
;
Hyeong Gon MOON
;
Soo Kyung AHN
;
Hee Chul SHIN
;
Jee Man YOU
;
Jung Min CHANG
;
Nariya CHO
;
Woo Kyung MOON
;
In Ae PARK
;
Dong Young NOH
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. hanw@snua.ac.kr
- Publication Type:Original Article
- Keywords:
Breast hyperplasia;
Breast neoplasms;
Diagnostic errors;
Needle biopsy
- MeSH:
Biopsy, Large-Core Needle;
Biopsy, Needle;
Breast Neoplasms;
Diagnostic Errors;
Female;
Humans;
Hyperplasia;
Multivariate Analysis;
Prospective Studies
- From:Journal of Breast Cancer
2012;15(4):407-411
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The need for surgical excision in patients with ultrasound-guided core needle biopsy (CNB)-diagnosed atypical ductal hyperplasia (ADH) remains an issue of debate. The present study sought to validate a scoring system (the U score, for underestimation) that we have previously developed for predicting malignancy in CNB-diagnosed ADH. METHODS: The study prospectively enrolled 85 female patients with CNB-diagnosed ADH who underwent subsequent surgical excision. Underestimation was defined as a surgical specimen having malignant foci. RESULTS: The overall underestimation rate was 37% (31/85). Multivariate analysis showed that a clinically palpable mass, microcalcification on imaging, size >15 mm and a patient age of > or =50 years were independently associated with underestimation. When applied to the scoring system, the validation score was significant (p<0.001; area under the curve, 0.852). No patient with a U score <3.5 had an underestimated lesion. CONCLUSION: The present study successfully validated the efficacy of our scoring system for predicting malignancy in CNB-diagnosed ADH. A U score of < or =3.5 indicates that surgical excision may not be necessary.
