Long term clinical follow-up of atypical ductal hyperplasia
and lobular carcinoma in situ in breast core needle biopsies.
Atypical ductal hyperplasia
at the margin of lumpectomy performed for early stage breast cancer: is there enough evidence to formulate guidelines?
Atypical lobular and atypical ductal hyperplasia
also differed in terms of the impact of menopausal status at the time of the benign breast biopsy on subsequent breast cancer risk.
Abbreviations: ADH, atypical ductal hyperplasia
; ALH, atypical lobular hyperplasia; DCIS, ductal carcinoma in situ; FEA, flat epithelial atypia; IC, invasive carcinoma; LCIS, lobular carcinoma in situ.
Atypical ductal hyperplasia
diagnosed at sonographically guided 14-gauge core needle biopsy of breast mass.
Age distributions of patients with carcinoma, atypical ductal hyperplasia
(ADH), and atypical lobular hyperplasia (ALH).
In 41-50 years of age group, 21 cases were seen, out of which fibroadenoma was seen in 05 cases (23.80%), fibrocystic disease seen in 04 cases (19.04%), 03 cases each of benign breast disease (14.28%), atypical ductal hyperplasia
(14.28%), breast abscess (14.28%), one case each of intraductal papilloma (4.76%), mastitis (4.76%) and one case of phylliodes (4.76%).
The remaining 82% (146 of 177) of MRI-guided biopsies were nonmalignant, of which 71% (126 of 177) revealed benign changes (or no pathologic findings) and 11% (20 of 177) showed epithelial atypia, which includes 17 cases of lobular neoplasia and 3 cases of atypical ductal hyperplasia
. Some of the atypical epithelial changes were identified in a background of benign changes.
Examples of usual ductal hyperplasia (A and B), atypical ductal hyperplasia
(C and D), and basal-like ductal carcinoma in situ (E and F) (hematoxylin-eosin, original magnification x400 [A, C, and E]; CK5, original magnification x400 [B, D, and F]).
(5-11) In atypical and in situ lesions, the use of ancillary studies such as additional levels improved diagnostic accuracy when compared with a reference panel of expert pathologists.12 Immunohistochemical (IHC) stains, second review, and changes in processing can be useful, especially in preventing overdiagnosis of atypias, such as atypical ductal hyperplasia
(ADH) (ie, false positives).
(10) However, we refer to IDPs with foci of architectural and cytologic atypia that quantitatively and qualitatively fail to fulfill criteria for the diagnosis of DCIS as papilloma with atypia or atypical papilloma; this diagnosis is equivalent to that of atypical ductal hyperplasia
elsewhere in the breast.
The authors selected challenging cases, including those originally diagnosed as atypical ductal hyperplasia
(ADH) with apocrine features, apocrine DCIS, or lesions with unusual apocrine cytology.