Safety of de-escalation of surgical intervention for atypical ductal hyperplasia on percutaneous biopsy: One size does not fit all |
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| Affiliation: | 1. The University of Kansas School of Medicine, Kansas City, KS, USA;2. Department of Surgery, The University of Kansas Health System, Kansas City, KS, USA;3. Department of Radiology, The University of Kansas Health System, Kansas City, KS, USA;4. Department of Internal Medicine, The University of Kansas Health System, Kansas City, KS, USA;1. University of South Dakota Sanford School of Medicine General Surgery Residency, Health Science Center, 1400 W 22nd St, Sioux Falls, SD, 57105, USA;2. Sanford Research, 2301 E 60th St, Sioux Falls, South Dakota, 57104, USA;3. Sanford USD Medical Center, 1305 W 18th St, Sioux Falls, South Dakota, 57117, USA |
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| Abstract: | BackgroundOncologic safety of active monitoring (AM) for atypical ductal hyperplasia (ADH) on core-needle biopsy (CNB) is not well defined. We sought to define oncologic outcomes for AM to manage ADH meeting institutional predefined low-risk criteria (LOW).MethodsADH was diagnosed on CNB from 10/2015-03/2020. LOW (pure ADH, size <1 cm, >50% removed by CNB, <3 foci, and no necrosis) patients were offered AM; all others were recommended for surgical excision. Oncologic outcomes were compared for AM and surgery.Results111 were included, 21 (19%) meeting LOW. AM occurred in 18 (86%) while 3 elected for excision (with 0% upgrade). Of the 18 LOW in AM, 2 required additional CNB (none at ADH site): 0% were diagnosed with cancer over median 23 month follow-up.ConclusionsThere were no missed cancers at ADH site during AM for LOW, confirming the oncologic safety of AM in this select group. |
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