Current 10-year risk of invasive breast cancer after a diagnosis of atypical ductal hyperplasia (ADH) may be lower than previously reported, a recent study found, and the risk associated with ADH is slightly lower for women whose ADH was diagnosed by needle core biopsy compared with excisional biopsy. The cohort study compared the 10-year cumulative risk of invasive breast cancer in 955,331 women (mean age at diagnosis, 52.6 years) undergoing mammography with and without a diagnosis of ADH. Researchers found:
• There were 1,727 diagnoses of ADH; 1,058 (61.3%) diagnosed by core biopsy and 635 (36.8%) by excisional biopsy.
• The proportion of ADH diagnosed by core needle biopsy increased from 21% to 77% from 1996 to 2012.
• The cumulative risk of invasive breast cancer 10 years following a diagnosis of ADH was 2.6 times higher than the risk in women with no ADH.
• ADH diagnosed via excisional biopsy was associated with an adjusted HR of 3.0 and via core needle biopsy, with an aHR of 2.2.
• 10 years after an ADH diagnosis, 5.7% of women in the study had a diagnosis of invasive breast cancer.
• Women with ADH diagnosed on excisional biopsy had a slightly higher risk compared with those with ADH diagnosed via core needle biopsy (6.7% vs 5%).
Menes TS, Kerlikowski K, Lange J, Jaffer S, Rosenberg R, Miglioretti DL. Subsequent breast cancer risk following diagnosis of atypical ductal hyperplasia on needle biopsy. [Published online ahead of print September 8, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2016.3022.