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The effect of delay of excisional biopsy on upstage rate for atypical ductal hyperplasia, flat epithelial atypia, intraductal papilloma, and radial scar.
Casaubon, Jesse; Niakan, Shiva; Vicks, Emily; Perez Coulter, Aixa; Jacobbe, Danielle L; Mason, Holly.
  • Casaubon J; Department of Surgery, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, 01199, USA. jesse.casaubon@baystatehealth.org.
  • Niakan S; Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, 01199, USA.
  • Vicks E; University of Massachusetts Chan Medical School, Worcester, MA, 01655, USA.
  • Perez Coulter A; Department of Surgery, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, 01199, USA.
  • Jacobbe DL; Office of Research, Epidemiology/Biostatistics Research Core, Baystate Medical Center, Springfield, MA, 01199, USA.
  • Mason H; Center for Cancer and Blood Disorders, Irving, TX, 75063, USA.
Breast Cancer Res Treat ; 196(3): 527-534, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2048350
ABSTRACT

PURPOSE:

When Core Needle Biopsy (CNB) demonstrates Atypical Ductal Hyperplasia (ADH), Flat Epithelial Atypia (FEA), Intraductal Papilloma (IDP), or Radial Scar/Complex Sclerosing Lesion (RS), excisional biopsy (EB) is often performed to rule out underlying malignancy with upstage rates (UR) ranging between 1 and 20%. The COVID-19 pandemic led to delayed EB for many patients. We sought to evaluate whether this delay was associated with higher UR.

METHODS:

We performed a retrospective analysis of women who underwent CNB and then EB for ADH, FEA, IDP, or RS between 2017 and 2021 using an IRB-approved repository. UR was evaluated by days between CNB and EB.

RESULTS:

473 patients met inclusion. 55 were upstaged to cancer (11.6%). 178 patients had pure ADH on CNB and 37 were upstaged (20.8%). 50 patients had pure FEA and 3 were upstaged (6%). 132 had pure IDP and 7 were upstaged (5.3%). 98 had pure RS and 1 was upstaged (1%). 7/15 (46.7%) had a combination of diagnoses or diagnosis with palpable mass and were upstaged. Days between CNB and EB were < 60 for 275 patients (58.1%), 60-90 for 108 (22.8%), 91-120 for 43 (9.1%), and > 120 for 47 (9.9%). There was no significant difference in UR (10.9% for < 60, 14.8% for 60-90, 7% for 90-120, and 12.8% for > 120, p = 0.54). UR for ADH was clinically increased after 60 days (27.8 vs. 17.5%), but this did not reach statistical significance (p = 0.1).

CONCLUSION:

Surgical delay was not associated with an increased UR.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / Carcinoma in Situ / Papilloma, Intraductal / Carcinoma, Intraductal, Noninfiltrating / Fibrocystic Breast Disease / COVID-19 / Inosine Diphosphate Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans Language: English Journal: Breast Cancer Res Treat Year: 2022 Document Type: Article Affiliation country: S10549-022-06745-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / Carcinoma in Situ / Papilloma, Intraductal / Carcinoma, Intraductal, Noninfiltrating / Fibrocystic Breast Disease / COVID-19 / Inosine Diphosphate Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans Language: English Journal: Breast Cancer Res Treat Year: 2022 Document Type: Article Affiliation country: S10549-022-06745-7