Valeur des macrobiopsies mammaires sous guidage stéréotaxique en cas de découverte d’unehyperplasie canalaire atypique

Value of stereotactic breastcore biopsy in patients with atypical ductal hyperplasia Purpose: Basedon a dual center retrospective study, the risks of under-diagnosingclusters of microcalcifications on core biopsies are analyzed. Imagingand histopathological factors affecting this risk are explored. Materialsand Methods: A total of 1,400 lesions (ACR BI-RADS2-5) were reviewed and analyzed for size, degree of excision (%),and histology result. A total of 381 patients underwentsurgery. Inter-center review of some histological slides was alsoperformed. Results: The rate of under-diagnosis was5.9% for ductal carcinoma in-situ (DCIS) and 12.5% foratypical ductal hyperplasia (ADH). Most cases of under-diagnosisinvolved clusters larger than 20 mm in diameter where thepercentage of excision decreased from 98% (clusters Conclusion: Thepresence of ADH on biopsy specimens requires surgical biopsy, butoptimal core biopsies with cluster removal and histological analysisby an experienced observer allows identification of low risk patientsthat could undergo close follow-up.