{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T20:37:44Z","timestamp":1773952664729,"version":"3.50.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T00:00:00Z","timestamp":1711756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Fibroadenomas (FAs) involved by atypia are rare. Consensus guidelines for management of FAs involved by atypia when diagnosed on image-guided biopsy do not exist because of limited data reporting surgical upgrade rates to ductal carcinoma in situ (DCIS) or invasive malignancy. Therefore, these lesions commonly undergo surgical excision.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This single-institution retrospective study identified cases of FAs involved by atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), and\/or lobular carcinoma in situ (LCIS) diagnosed on image-guided biopsy between January 2014 and April 2023 to determine upgrade rates. Cases with incidental atypia adjacent to but not involving FAs were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1736 FAs diagnosed on image-guided biopsy, 32 cases (1.8%) were FAs involved by atypia including 43.8% (14\/32) ALH, 28.1% (9\/32) ADH, 18.8% (6\/32) LCIS, 6.3% (2\/32) LCIS + ALH, and 3.1% (1\/32) unspecified atypia. The most common imaging finding was a mass. Most cases, 81.3% (26\/32), underwent subsequent surgical excisional biopsy. A single case of ADH involving and adjacent to an FA was upgraded to FA involved by low-grade DCIS on excision for an overall surgical upgrade rate of 3.8%. There were no cases upgraded to invasive malignancy. For those omitting surgical excision, there was no subsequent malignancy diagnosis at the FA biopsy site over a mean follow-up of 73 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Cases of radiologic-pathologic concordant FAs involved by atypia have a low upgrade rate of 3.8% and should undergo multidisciplinary review. Larger multi-institutional analysis is needed to determine whether guidelines for excision of atypia should apply to atypia involving FAs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jbi\/wbae013","type":"journal-article","created":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T16:11:01Z","timestamp":1711815061000},"page":"254-260","source":"Crossref","is-referenced-by-count":3,"title":["Atypia Involving Fibroadenomas: Outcomes and Upgrade Rates"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7379-6025","authenticated-orcid":false,"given":"Allison","family":"Aripoli","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onalisa","family":"Winblad","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christa","family":"Balanoff","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camron","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5571-5682","authenticated-orcid":false,"given":"Ashley","family":"Huppe","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Wermuth","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nika","family":"Gloyeske","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,3,30]]},"reference":[{"issue":"1","key":"2024052713432984500_CIT0001","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1002\/1097-0142(20010701)92:1<30::AID-CNCR1288>3.0.CO;2-2","article-title":"No elevation in long-term breast carcinoma risk for women with fibroadenomas that contain atypical hyperplasia","volume":"92","author":"Carter","year":"2001","journal-title":"Cancer"},{"key":"2024052713432984500_CIT0002","first-page":"72","article-title":"Fibroadenoma and related lesions","volume-title":"Diagnostic Histopathology of the Breast","author":"Fechner","year":"1987"},{"issue":"6","key":"2024052713432984500_CIT0003","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1111\/j.1445-2197.1998.tb04790.x","article-title":"Newly arising fibroadenomas in women aged 35 and over","volume":"68","author":"Foxcroft","year":"1998","journal-title":"Aust NZ J Surg"},{"issue":"5","key":"2024052713432984500_CIT0004","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0960-9776(03)00123-1","article-title":"Systematic review of fibroadenoma as a risk factor for breast cancer","volume":"12","author":"El-Wakeel","year":"2003","journal-title":"Breast"},{"key":"2024052713432984500_CIT0005","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1186\/1477-7819-12-335","article-title":"Breast cancer arising within fibroadenoma: collective analysis of case reports in the literature and hints on treatment policy","volume":"12","author":"Wu","year":"2014","journal-title":"World J Surg Oncol"},{"issue":"4","key":"2024052713432984500_CIT0006","first-page":"372","article-title":"Beware of breast fibroadenomas in middle-aged women","volume":"28","author":"Desch\u0207nes","year":"1985","journal-title":"Can J Surg"},{"issue":"4","key":"2024052713432984500_CIT0007","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1080\/00313029800169736","article-title":"Breast carcinoma in a fibroadenoma: diagnosis by fine needle aspiration cytology","volume":"30","author":"Psarianos","year":"1998","journal-title":"Pathology"},{"issue":"5","key":"2024052713432984500_CIT0008","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/ajcp\/95.5.614","article-title":"Carcinoma arising within fibroadenomas of the breast. 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