{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:16:37Z","timestamp":1791314197787,"version":"4.3.1"},"reference-count":41,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T00:00:00Z","timestamp":1624060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>(1) Background: to evaluate which factors can reduce the upgrade rate of atypical ductal hyperplasia (ADH) to in situ or invasive carcinoma in patients who underwent vacuum-assisted breast biopsy (VABB) and subsequent surgical excision. (2) Methods: 2955 VABBs were reviewed; 141 patients with a diagnosis of ADH were selected for subsequent surgical excision. The association between patients\u2019 characteristics and the upgrade rate to breast cancer was evaluated in both univariate and multivariate analyses. (3) Results: the upgrade rates to ductal carcinoma in situ (DCIS) and invasive carcinoma (IC) were, respectively, 29.1% and 7.8%. The pooled upgrade rate to DCIS or IC was statistically lower at univariate analysis, considering the following parameters: complete removal of the lesion (p-value &lt; 0.001); BIRADS \u2264 4a (p-value &lt; 0.001); size of the lesion \u226415 mm (p-value: 0.002); age of the patients &lt;50 years (p-value: 0.035). (4) Conclusions: the overall upgrade rate of ADH to DCIS or IC is high and, as already known, surgery should be recommended. However, ADH cases should always be discussed in multidisciplinary meetings: some parameters appear to be related to a lower upgrade rate. Patients presenting these parameters could be strictly followed up to avoid overtreatment.<\/jats:p>","DOI":"10.3390\/diagnostics11061120","type":"journal-article","created":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T22:00:02Z","timestamp":1624226402000},"page":"1120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?"],"prefix":"10.3390","volume":"11","author":[{"given":"Luca","family":"Nicosia","sequence":"first","affiliation":[{"name":"Department of Breast Radiology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antuono","family":"Latronico","sequence":"additional","affiliation":[{"name":"Department of Breast Radiology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Addante","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation, Section of Anatomic Pathology, School of Medicine, University \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"De Santis","sequence":"additional","affiliation":[{"name":"Postgraduate School in Radiology, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Carla","family":"Bozzini","sequence":"additional","affiliation":[{"name":"Department of Breast Radiology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Montesano","sequence":"additional","affiliation":[{"name":"Department of Breast Radiology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuele","family":"Frassoni","sequence":"additional","affiliation":[{"name":"Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Bagnardi","sequence":"additional","affiliation":[{"name":"Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Mazzarol","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriana","family":"Pala","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2162-4002","authenticated-orcid":false,"given":"Matteo","family":"Lazzeroni","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Genetics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germana","family":"Lissidini","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8306-0839","authenticated-orcid":false,"given":"Mauro Giuseppe","family":"Mastropasqua","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation, Section of Anatomic Pathology, School of Medicine, University \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Cassano","sequence":"additional","affiliation":[{"name":"Department of Breast Radiology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.ejso.2016.07.011","article-title":"Clinical and pathological assessment of high-risk ductal and lobular breast lesions: What surgeons must know","volume":"43","author":"Mastropasqua","year":"2017","journal-title":"Eur. 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