대한유방검진의학회

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Background: The purpose of this study was to evaluate the outcomes of atypical ductal hyperplasia (ADH) on vacuum-assisted breast biopsy (VAB), and compare the results according to the lesion types; mass or microcalcifications. Materials and Methods: A retrospective study was performed in 31 women (mean age, 45.7±8.8 years) who underwent subsequent surgery for ADH diagnosed via VAB for imaging abnormalities observed on mammography and ultrasound. The imaging findings, histopathologic diagnosis of all VAB and surgical specimens, and association of malignancy with residual lesions were evaluated. Results: Among 31 women (mean age: 45.7±8.8 years) with histologically confirmed pure ADH, mammography revealed microcalcifications in 26 cases, while ultrasound detected masses in 5 cases. Subsequent surgical excision after VAB was conducted in 21 cases, resulting in 4 cases being upgraded to ductal carcinoma in situ (DCIS). Notably, all cases upgraded to DCIS exhibited residual microcalcifications on mammography after VAB. Conversely, lesions without residual microcalcifications remained as ADH. Masses detected on ultrasound in five cases were removed via VAB without evidence of residual lesion on images, and follow-up ultrasound over 2 years showed negative results. Conclusion: In conclusion, follow up US is enough for ADH diagnosed after US-guided VAB removal for the mass without calcifications. ADH diagnosed after VAB for suspicious microcalcifications needs further surgical excision especially when there is residual calcification.
Key Words: Atypical Ductal Hyperplasia (ADH), Vacuum-Assisted Breast Biopsy (VAB), Lesion Types: Mass, Microcalcifications