{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T02:47:41Z","timestamp":1785034061444,"version":"3.55.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"1085","license":[{"start":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T00:00:00Z","timestamp":1519344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>Atypical ductal hyperplasia (ADH) is a proliferative lesion associated with a variable increased risk of breast malignancy, but the management of the patients is still not completely defined, with mandatory surgical excision in most cases. To report the results of the conservative management with mammographic checks of patients with ADH diagnosed by vacuum assisted breast biopsy (VAB), without residual calcifications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>The authors accessed the institutional database of radiological, surgical and pathological anatomy. Inclusion criteria were: ADH diagnosed by VAB on a single group of microcalcifications, without residual post-procedure; follow-up at least of 12 months. Exclusion criteria were the presence of personal history of breast cancer or other high-risk lesions; association with other synchronous lesions, both more and less advanced proliferative lesions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>The 65 included patients were all females, with age range of 40\u201379 years (mean 54 years). The maximum diameter range of the groups of microcalcifications was 4\u201311 mm (mean 6.2 mm), all classified as BI-RADS 4b (Breast Imaging Reporting and Data System 4b) and defined as fine pleomorphic in 29 cases (45%) or amorphous in 36 cases (55%). The range of follow-up length was 12\u2013156 months (mean 67 months). Only one patients developed new microcalcifications, in the same breast, 48 months after and 15 mm from the first VAB, interpreted as low-grade ductal carcinoma in situ (DCIS) at surgical excision.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>These results could justify the conservative management, in a selected group of patients, being the malignancy rate lower than 2%, considered in the literature as the \u201cprobably benign\u201d definition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>Increasing the length of follow-up of selected patients conservatively managed can improve the management of ADH cases.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20180003","type":"journal-article","created":{"date-parts":[[2018,2,16]],"date-time":"2018-02-16T13:54:18Z","timestamp":1518789258000},"source":"Crossref","is-referenced-by-count":22,"title":["Vacuum assisted breast biopsy (VAB) excision of subcentimeter microcalcifications as an alternative to open biopsy for atypical ductal hyperplasia"],"prefix":"10.1093","volume":"91","author":[{"given":"Simone","family":"Schiaffino","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Genoa , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Massone","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Genoa , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licia","family":"Gristina","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Genoa , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Fregatti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Policlinico San Martino , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rescinito","sequence":"additional","affiliation":[{"name":"Department of Radiology, Policlinico San Martino , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Villa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ospedale San Bartolomeo , Sarzana , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Policlinico San Martino , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Genoa , Genoa , Italy"},{"name":"Department of Radiology, Policlinico San Martino , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,2,23]]},"reference":[{"key":"2024050214204227200_b1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1158\/1940-6207.CAPR-13-0222","article-title":"Understanding the premalignant potential of atypical hyperplasia through its natural history: a longitudinal cohort study","volume":"7","author":"Hartmann","year":"2014","journal-title":"Cancer Prev Res"},{"key":"2024050214204227200_b2","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1148\/radiol.2242011528","article-title":"Atypical ductal hyperplasia: can some lesions be defined as probably benign after stereotactic 11-gauge vacuum-assisted biopsy, eliminating the recommendation for surgical excision?","volume":"224","author":"Jackman","year":"2002","journal-title":"Radiology"},{"key":"2024050214204227200_b3","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0221-0363(04)97598-1","article-title":"Underestimation of breast carcinoma with 11-gauge stereotactically guided directional vacuum-assisted biopsy","volume":"85","author":"Plantade","year":"2004","journal-title":"J Radiol"},{"key":"2024050214204227200_b4","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0221-0363(06)74005-7","article-title":"Non-palpable breast lesions and core needle biopsy with mammotome 11G: is surgery required in patients with atypical ductal hyperplasia?","volume":"87","author":"Travade","year":"2006","journal-title":"J Radiol"},{"key":"2024050214204227200_b5","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.amjsurg.2007.07.038","article-title":"Is surgical biopsy mandatory in case of atypical ductal hyperplasia on 11-gauge core needle biopsy? 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