Table 3.
Histologic Features Present in Cases Identified as ADH by Consensus Experts (N=72) Stratified by Participant Diagnosis
| Study Participant Diagnosis | |||||||
|---|---|---|---|---|---|---|---|
| Lesion Features | Number of cases | Number of assessments N (Row %) | Benign | FEA or LN | ADH | DCIS | Invasive |
| Total | 72 | 2070 (100%) | 512 (25%) | 207 (10%) | 990 (48%) | 353 (17%) | 8 (<0.1%) |
| Papillary lesion? | |||||||
| No | 58 | 1667 (100%) | 421 (25%) | 204 (12%) | 765 (46%) | 275 (16%) | 2 (<0.1%) |
| Yes | 14 | 403 (100%) | 91 (23%) | 3 (1%) | 225 (56%) | 78 (19%) | 6 (1%) |
| Architecture pattern present in lesion: | |||||||
| Cribiform | 55 | 1579 (100%) | 429 (27%) | 107 (7%) | 801 (51%) | 235 (15%) | 7 (<0.1%) |
| Flat | 3 | 89 (100%) | 16 (18%) | 13 (15%) | 47 (53%) | 13 (15%) | 0 (<0.1%) |
| Micropapillary | 9 | 259 (100%) | 54 (21%) | 34 (13%) | 103 (40%) | 68 (26%) | 0 (<0.1%) |
| Solid | 5 | 143 (100%) | 13 (9%) | 53 (37%) | 39 (27%) | 37 (26%) | 1 (1%) |
| Specimen Type: | |||||||
| Core | 48 | 1381 (100%) | 328 (24%) | 108 (8%) | 685 (50%) | 253 (18%) | 7 (1%) |
| Excision | 24 | 689 (100%) | 184 (27%) | 99 (14%) | 305 (44%) | 100 (15%) | 1 (<0.1%) |
| Cytologic monotony in lesion: | |||||||
| Very | 52 | 1495 (100%) | 322 (22%) | 152 (10%) | 742 (50%) | 272 (18%) | 7 (<0.1%) |
| Borderline with UDH | 20 | 575 (100%) | 190 (33%) | 55 (10%) | 248 (43%) | 81 (14%) | 1 (<0.1%) |
| Diagnostic area obvious on low power?a | |||||||
| No | 15 | 431 (100%) | 130 (30%) | 61 (14%) | 193 (45%) | 46 (11%) | 1 (<0.1%) |
| Yes | 48 | 1381 (100%) | 321 (23%) | 88 (6%) | 687 (50%) | 279 (20%) | 6 (<0.1%) |
| Borderline | 8 | 229 (100%) | 61 (27%) | 43 (19%) | 96 (42%) | 28 (12%) | 1 (<0.1%) |
| Number of foci with atypia: | |||||||
| 1–2 foci | 21 | 601 (100%) | 215 (36%) | 76 (13%) | 264 (44%) | 45 (7%) | 1 (<0.1%) |
| 3–5 foci | 29 | 834 (100%) | 213 (26%) | 67 (8%) | 420 (50%) | 133 (16%) | 1 (<0.1%) |
| 6+ foci | 22 | 635 (100%) | 84 (13%) | 64 (10%) | 306 (48%) | 175 (28%) | 6 (1%) |
| Number regions of interest (ROI) to screen a: | |||||||
| 1–2 foci | 30 | 859 (100%) | 222 (26%) | 85 (10%) | 420 (49%) | 126 (15%) | 6 (1%) |
| 3–5 foci | 30 | 869 (100%) | 196 (23%) | 79 (9%) | 417 (48%) | 175 (20%) | 2 (<0.1%) |
| >5 foci | 11 | 313 (100%) | 91 (29%) | 34 (11%) | 138 (44%) | 50 (16%) | 0 (<0.1%) |
| Distracting Areas? | |||||||
| No | 53 | 1528 (100%) | 379 (25%) | 137 (9%) | 743 (49%) | 267 (17%) | 2 (<0.1%) |
| Yes | 19 | 542 (100%) | 133 (25%) | 70 (13%) | 247 (46%) | 86 (16%) | 6 (1%) |
| Other diagnosis in Ddx or within the lesion a: | |||||||
| No | 23 | 662 (100%) | 198 (30%) | 34 (5%) | 329 (50%) | 101 (15%) | 0 (<0.1%) |
| Yes | 48 | 1379 (100%) | 308 (22%) | 173 (13%) | 647 (47%) | 249 (18%) | 2 (<0.1%) |
| Number of areas with atypiaa: | |||||||
| 1 | 46 | 1324 (100%) | 343 (26%) | 164 (12%) | 620 (47%) | 196 (15%) | 1 (<0.1%) |
| 2 | 17 | 493 (100%) | 113 (23%) | 36 (7%) | 246 (50%) | 91 (18%) | 7 (1%) |
| 3+ | 7 | 199 (100%) | 34 (17%) | 7 (4%) | 99 (50%) | 59 (30%) | 0 (<0.1%) |
| Largest area with atypiaa: | |||||||
| <2.5 | 34 | 979 (100%) | 264 (27%) | 119 (12%) | 460 (47%) | 134 (14%) | 2 (<0.1%) |
| ≥2.5 | 37 | 1062 (100%) | 234 (22%) | 79 (7%) | 524 (49%) | 219 (21%) | 6 (1%) |
| Largest single discrete focus: | |||||||
| ≤2mm | 58 | 1665 (100%) | 433 (26%) | 180 (11%) | 791 (48%) | 259 (16%) | 2 (<0.1%) |
| > 2mm | 14 | 405 (100%) | 79 (20%) | 27 (7%) | 199 (49%) | 94 (23%) | 6 (1%) |
| Apocrine cytology? | |||||||
| No | 67 | 1927 (100%) | 485 (25%) | 198 (10%) | 914 (47%) | 322 (17%) | 8 (<0.1%) |
| Yes | 5 | 143 (100%) | 27 (19%) | 9 (6%) | 76 (53%) | 31 (22%) | 0 (<0.1%) |
| Hyperchromatic nuclei? | |||||||
| No | 57 | 1631 (100%) | 428 (26%) | 158 (10%) | 793 (49%) | 245 (15%) | 7 (<0.1%) |
| Yes | 15 | 439 (100%) | 84 (19%) | 49 (11%) | 197 (45%) | 108 (25%) | 1 (<0.1%) |
| Nucleoli present? | |||||||
| No | 59 | 1695 (100%) | 436 (26%) | 162 (10%) | 809 (48%) | 287 (17%) | 1 (<0.1%) |
| Yes | 13 | 375 (100%) | 76 (20%) | 45 (12%) | 181 (48%) | 66 (18%) | 7 (2%) |
| Calcifications present in lesion? | |||||||
| No | 43 | 1235 (100%) | 345 (28%) | 106 (9%) | 601 (49%) | 175 (14%) | 8 (1%) |
| Yes | 29 | 835 (100%) | 167 (20%) | 101 (12%) | 389 (47%) | 178 (21%) | 0 (<0.1%) |
| Development of architecture in lesion: | |||||||
| Well/Solid | 14 | 409 (100%) | 59 (14%) | 51 (12%) | 189 (46%) | 103 (25%) | 7 (2%) |
| Partial/No or Subtle | 56 | 1604 (100%) | 443 (28%) | 151 (9%) | 768 (48%) | 241 (15%) | 1 (<0.1%) |
| Uniformity of process in lesion: | |||||||
| Uniform | 53 | 1519 (100%) | 393 (26%) | 148 (10%) | 729 (48%) | 242 (16%) | 7 (<0.1%) |
| Partial | 18 | 522 (100%) | 119 (23%) | 44 (8%) | 247 (47%) | 111 (21%) | 1 (<0.1%) |
FEA = flat epithelial atypia, LN = lobular neoplasia (atypical lobular hyperplasia or lobular carcinoma in situ), ADH= atypical ductal hyperplasia and intraductal papilloma with atypical ductal hyperplasia, DCIS = ductal carcinoma in situ.
a
For these features, there were rare cases in which there was no agreement on the scoring (using the 3 reviewing pathologist scores). This occurred in < 1% of all assessments (8/1224) and they were not included in the overall scoring for that histologic feature.