Affiliations: [a] Division of Surgical Oncology, Department of Surgery, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA | [b] Department of General Surgery, University of Ondokuz Mayıs Faculty of Medicine, Samsun, Turkey | [c] Department of Pathology - Magee-Womens Hospital of UPMC, University of Pittsburgh, Pittsburgh, PA, USA
Correspondence:
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Corresponding author: Atilla Soran, Magee-Womens Hospital of University of Pittsburgh Medical Center, 300 Halket St, Ste 2601, Pittsburgh, PA, USA. Tel.: +1 412 641 1316; Fax: +1 422 641 1446; E-mail:asoran@upmc.edu
Abstract: BACKGROUND: Atypical Ductal Hyperplasia (ADH) is a disease of the
proliferative breast lesion characterized with atypia and when diagnosed on
core needle biopsy (CNB), excisional biopsy is the current management to
exclude adjacent cancer, which may found 10 to 20%.
OBJECTIVE: The purpose of the study is to investigate the role of
biomarkers on surgical decision after the diagnosis of ADH on CNB.
METHODS: Patients with pure ADH on core biopsy were retrospectively
selected, and categorized according to final pathology after excision into
three groups: Group I (n: 39) ADH; Group II (n: 27) ductal carcinoma in situ
(DCIS), and Group III (n: 9) invasive cancer (IC). Immunohistochemical
analyses were performed using biomarkers MUC1, Ki67, Cyclin B1, and Cyclin
D1.
RESULTS: Only Cyclin D1 was significant in between group analysis
by one-way ANOVA (64.74, 49.44, and 51.11, respectively; p= 0.01).
However when appropriate cut-off levels (2%-50%) were used for each
biomarkers using X2 test, no statistical significance was found.
CONCLUSION: MUC1, Ki67, Cyclin B, and Cyclin D1have failed to
predict adjacent cancer on core biopsy specimens with ADH. Further surgery
is warranted for all ADH cases diagnosed on core biopsies until a new
predictor is identified.
Keywords: Atypical ductal hyperplasia, breast cancer, biomarker, MUC1, cyclin, Ki67
