10-Year Risk of Invasive Breast Cancer After Diagnosis of Atypical Ductal Hyperplasia by Needle Biopsy
The cumulative estimated risk of invasive breast cancer at 10 years after diagnosis of atypical ductal hyperplasia by core-needle biopsy was approximately 5%, according to a study reported by Menes et al in JAMA Oncology. The 10-year risk was 6.7% with atypical ductal hyperplasia diagnosed by excisional biopsy.
Study Details
The cohort study involved data on 955,331 women undergoing mammography with and without a diagnosis of atypical ductal hyperplasia from 5 breast-imaging registries in the Breast Cancer Surveillance Consortium. Among these women, 1,727 had a diagnosis of atypical ductal hyperplasia; of them, 1,058 (61.3%) were diagnosed by core biopsy and 635 (36.8%) were diagnosed by excisional biopsy. Median age at diagnosis was 52.6 years (interquartile range = 46.9–60.4 years). Analysis of risk was adjusted for age and age-squared at baseline, ethnicity, Breast Imaging Reporting and Data System density, family history, and mammography type.
Risk of Invasive Cancer
From 1996 to 2012, the proportion of atypical ductal hyperplasia diagnosed by core-needle biopsy increased from 21% to 77%. Compared with women with no atypical ductal hyperplasia at baseline, the adjusted hazard ratio for 10-year risk of invasive cancer was 2.6 (95% confidence interval [CI] = 2.0–3.4) among all women diagnosed with atypical ductal hyperplasia. Adjusted hazard ratios were 3.0 (95% CI = 2–4.5) among those diagnosed by excisional biopsy and 2.2 (95% CI = 1.5–3.4) among those diagnosed by core-needle biopsy.
At 10 years after atypical ductal hyperplasia diagnosis, an estimated 5.7% of women had a diagnosis of invasive cancer, including 6.7% of those diagnosed by excisional biopsy and 5% of those diagnosed by core-needle biopsy.
The investigators concluded: “Current 10-year risks of invasive breast cancer after a diagnosis of [atypical ductal hyperplasia] may be lower than those previously reported. The risk associated with [atypical ductal hyperplasia] is slightly lower for women whose [atypical ductal hyperplasia] was diagnosed by needle core biopsy compared with excisional biopsy.”
The study was supported by a grant from the National Cancer Institute–funded Breast Cancer Surveillance Consortium and the National Cancer Institute.
Tehillah S. Menes, MD, of Tel Aviv Sourasky Medical Center, is the corresponding author of the JAMA Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
