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KMID : 1134120120150040407
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Journal of Breast Cancer
2012 Volume.15 No. 4 p.407 ~ p.411
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Validation of a Scoring System for Predicting Malignancy in Patients Diagnosed with Atypical Ductal Hyperplasia Using an Ultrasound-Guided Core Needle Biopsy
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Kim Ji-Sun
Han Won-Shik
Moon Hyeong-Gon
Ahn Soo-Kyung
Noh Dong-Young
Go Eun-Young
Shin Hee-Chul
You Jee-Man
Chang Jung-Min
Cho Nariya
Moon Woo-Kyung
Park In-Ae
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Abstract
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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 ≥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 ≤3.5 indicates that surgical excision may not be necessary.
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KEYWORD
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Breast hyperplasia, Breast neoplasms, Diagnostic errors, Needle biopsy
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