Atypical ductal hyperplasia
Citation, DOI & article data
Atypical ductal hyperplasia is a histologically borderline lesion that has some, but not all, of the features of ductal carcinoma in situ. Sometimes the distinction between Atypical ductal hyperplasia and ductal carcinoma in situ are simply defined on the number of ducts involved.
Atypical ductal hyperplasia is a lesion with malignant potential. It lacks the strict criteria for ductal carcinoma in situ, with <2 ducts involved 3.
Grouped or regional amorphous calcifications. Less likely are punctate or fine pleomorphic calcifications 6.
Solid or intracystic mass.
Non-specific features on MRI range from a round, oval or irregular mass to non-mass enhancement in a focal, linear, segmental or regional distribution 6.
Treatment and prognosis
Atypical ductal hyperplasia is considered a high-risk breast lesion. Therefore surgical excision is advised as under-estimation of ductal carcinoma in situ is encountered when atypical ductal hyperplasia is retrieved on a large core needle biopsy (up to one-third of cases may be upstaged to ductal carcinoma in situ). Tamoxifen may be used as a chemopreventative agent.
- 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
- 6. Wendie A. Berg, Jessica Leung. Diagnostic Imaging: Breast. (2019) ISBN: 9780323548120