Question: After several years of mammograms showing mild calcifications, this year I was informed that the radiologist saw some mild changes in the calcifications. I did another mammogram, followed by a core biopsy. The initial report came back benign, but the final came back as atypical ductal hyperplasia. I am now scheduled for surgical excision of the area. How are they able to remove the proper area, and how often do they find more invasive cells or even cancers with this procedure?

Answer: A core needle biopsy is just an initial sampling of an area that the breast imager finds suspicious. The data in the literature regarding core biopsy and the finding of atypical ductal hyperplasia suggest that in 20-30% of the time there is a “more significant” lesion such as in situ or invasive carcinoma following complete excision of the suspicious area. That also means that in the majority of time there is nothing more than atypical ductal hyperplasia found at surgery.

I didn’t read in your question if the report indicated that the atypical ductal hyperplasia was associated with the calcifications. Depending on how large the area of calcifications spans, the breast imager usually performs a needle localization which helps the surgeon localize the area of concern to be removed at the time of your operation. That portion of breast tissue will be sent to the pathology laboratory for evaluation. I hope all goes well and the pathologist finds nothing more than atypical ductal hyperplasia. Best wishes.