Accuracy of stereotactic core-needle breast biopsy in atypical ductal hyperplasia

background The histologic diagnosis of atypical ductal hyperplasia (ADH) has been reported as having a high rate of malignancy, either ductal carcinoma in situ (DCIS) or invasive ductal carcinoma (IDC). We reviewed our surgical groupʹs experience with stereotactic core-needle biopsies (SCNB), specifically looking at the follow-up of ADH. methods From November 1994 through July 1997 our group performed 539 SCNB. Twentyone patients (4%) were diagnosed as ADH. Eighteen patients had subsequent wire-localized excisional biopsies. Three patients were followed up mammographically. One patient refused follow-up. results: Of the 18 patients who underwent excisional biopsies, 2 patients were found to have DCIS and 1 patient had lobular carcinoma in-situ. There were no cases of IDC. conclusion Our results show a much lower incidence of malignancy in cases of ADH found on SCNB than has been previously reported. While the standard of care is still to follow up ADH found on SCNB with excisional biopsy, more data may justify following up certain subsets of patients.