Atypical ductal hyperplasia (ADH) is a histologically borderline lesion that has some, but not all the features of ductal carcinoma in situ (DCIS). Sometimes the distinction between ADH and DCIS is simply on the basis of the number of ducts involved 5.
Atypical ductal hyperplasia lacks the strict criteria for ductal carcinoma in situ. Involvement of a single duct or an aggregate diameter of involvement of less that 2 mm constitutes a diagnosis of atypical ductal hyperplasia, and a more extensive lesion with the same histologic features is labeled ductal carcinoma in situ.
Treatment and prognosis
ADH is considered a high risk breast lesion. Therefore surgical excision is advised as under-estimation of ductal carcinoma in situ encountered when atypical ductal hyperplasia is retrieved on a large core needle biopsy (up to a 3rd of cases may be upstaged to DCIS).
- 1. Darling ML, Smith DN, Lester SC et-al. Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: results of surgical excision. AJR Am J Roentgenol. 2000;175 (5): 1341-6. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Jackman RJ, Burbank F, Parker SH et-al. Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy. Radiology. 1997;204 (2): 485-8. Radiology (abstract) - Pubmed citation
- 3. Moore MM, Hargett CW, Hanks JB et-al. Association of breast cancer with the finding of atypical ductal hyperplasia at core breast biopsy. Ann. Surg. 1997;225 (6): 726-31. Ann. Surg. (link) - Free text at pubmed - Pubmed citation
- 4. Albarracin CT, Nguyen CV, Whitman GJ et-al. Identifying patients with atypical ductal hyperplasia diagnosed at core-needle biopsy who are at low risk of malignancy. Radiology. 2010;257 (3): 893-4. doi:10.1148/radiol.101253 - Pubmed citation
- 5. Paredes ES. Atlas of mammography. Lippincott Williams & Wilkins. (2007) ISBN:0781764335. Read it at Google Books - Find it at Amazon
Synonyms & Alternative Spellings
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|Atypical ductal hyperplasia (ADH)||✗|