Atypical ductal hyperplasia – Benign lesion with malignant potential: A case report (original) (raw)
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The Breast Journal, 2001
by SCNB, a surgical biopsy showed DCIS in 55 (71%) cases, 6 more cases (8%) had DCIS with focal microinvasion, and 15 (19%) had invasive ductal carcinoma. In one case no residual tumor was found at surgery. In the author's patient population, the diagnosis of ADH at SCNB indicates high probability of DCIS or residual ADH in the surgical biopsy. The diagnosis of DCIS at SCNB is confirmed in the majority of surgical biopsies; however, a significant number of cases may show microinvasion or invasive carcinoma.
Current Diagnostic Pathology
Atypical epithelial proliferations of the breast are now seen more often by histopathologists as a result of mammographic breast screening programmes and, on occasion, these lesions may cause significant diagnostic and clinical difficulties. Perhaps in part, because of the greater frequency of identification, it has been recognized that there are imperfections in the criteria used to define atypical ductal hyperplasia (ADH). It is also becoming more widely accepted that ductal carcinoma in situ (DCIS) of the breast is a heterogeneous disease and several systems for subtyping this lesion have been described. We aim here to describe the histopathological features of ADH and DCIS, and to address these recent changes in criteria for diagnosis and classification. In addition we review the appearances of atypical apocrine proliferations which may cause particular difficulties with regard to classification.
Subsequent Breast Cancer Risk Following Diagnosis of Atypical Ductal Hyperplasia on Needle Biopsy
JAMA Oncology, 2017
Background-Atypical ductal hyperplasia (ADH) is a known strong risk factor for breast cancer. Published risk estimates are based on cohorts that included women diagnosed prior to the widespread use of screening mammograms and do not differentiate between the methods used to diagnose ADH, which may be related to size of the ADH focus. These risks may overestimate the risk of women currently diagnosed with ADH. We sought to examine the risk of invasive cancer associated with ADH diagnosed on core needle biopsy versus excisional biopsy. Design-Cohort study comparing ten-year cumulative risk of invasive breast cancer in women undergoing mammography with and without a diagnosis of ADH. Setting-Five breast imaging registries that participate in the National Cancer Institute-funded Breast Cancer Surveillance Consortium (BCSC). Participants-Women undergoing mammography in the BCSC. Exposure-Diagnosis of ADH on core needle biopsy or excisional biopsy in women undergoing mammography. Main outcome-Ten-year cumulative risk of invasive breast cancer risk.
Unilateral Usual Ductal Hyperplasia in A 22 Years Old Male Patient: A Case Report
JBN (Jurnal Bedah Nasional), 2019
Background: Benign breast disease have been broadly classified into non-proliferative lesions, proliferative lesions without atypia and hyperplasia with atypia. Proliferative disease, such as usual ductal hyperplasia, is associated with a 1.5 to 2 fold increased risk of developing invasive carcinoma. We reported a case of usual ductal hyperplasia in a young male. Case: A 22-year-old male complained of discomfort and enlargement of unilateral breast. Physical examination at that time revealed a palpable mass in the lateral upper quadrant of the patient’s left breast, three centimeters from nipple areola complex. The examination of axilla didn’t reveal any lymph node enlargement on both sides. His vital signs were normal without any abnormalities found on examination. Ultrasonography examination demonstrated fibroglandular tissue in the left breast with the volume of 11.13 cm3, consist of 4.8 cm length, 2.9 cm width and 0.8 cm depth. Excisional tumor biopsy was done on his left breast...
Ductal intraepithelial neoplasia of the breast
Virchows Archiv, 2001
Keywords Breast carcinoma · Ductal in situ carcinoma · Intraductal hyperplasia · Atypical intraductal hyperplasia · Ductal intraepithelial neoplasia Two to three decades ago, a majority of breast carcinomas were invasive at the time of detection. Among the relatively uncommon in situ carcinomas, a majority presented as palpable masses that were predominantly a morphologically high-grade ductal in situ carcinoma (DCIS). The definition of in situ carcinoma emphasized the absence of stromal invasion, indicating that the major diagnostic issue was separation of an invasive from a generally florid, high-grade in situ carcinoma. Simple mastectomy was the accepted treatment for in situ carcinomas, whether ductal or lobular in type.
American Journal of Roentgenology, 2009
ercutaneous imagingguided core needle biopsy is increasingly being used as a faster, less in vasive, and less expensive alter native to surgical biopsy for the histologic assessment of breast lesions [1]. This technique has been proved reliable and accurate in the diagnosis of both benign and malignant diseases of the breast [2-4]. However, the core needle biopsy finding of atypical ductal hyperplasia (ADH) is less reliable owing to histologic underestimation of malignancy, that is, upgrade of the result to ductal carci noma in situ (DCIS) or invasive cancer at surgical excision. The rate of underestimation of ADH has been reported to be 11-75% for 14gauge core needle biopsy [5, 6]. Therefore, there seems to be a consensus on the need for surgical excision when ADH is diagnosed at core needle biopsy [7]. The widespread practice of mammog raphic screening for breast cancer has led to
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2005
To evaluate breast cancer underestimation rate of atypical ductal hyperplasia (ADH) diagnosed by core-needle biopsy (CNB) under imaging guidance in Ramathibodi Hospital and to determine the difference between the malignant and benign groups in terms of clinical and imaging characteristics. The pathological records of 1521 patients who underwent CNB under imaging guidance were reviewed. Thirty-nine patients diagnosed with ADH were enrolled into the present study. Clinical data, imaging features, biopsy technique and result of excisional biopsy as well as follow-up data were retrospectively reviewed. Of 39 ADH cases, eight (20.5%) were found to have malignancy on subsequent excisional biopsy. The majority of these were ductal carcinoma in situ (DCIS) (62.5%). Lesion categorized as category 5 according to BI-RADS (Breast imaging reporting and data system) was the only feature which was statistically different between the benign and malignant groups. No statistically significant differe...
Usual and atypical ductal hyperplasia—members of the same family?
Current Diagnostic Pathology, 2004
Among the intraductal lesions, usual ductal hyperplasia, atypical ductal hyperplasia and ductal carcinoma in situ play a pivotal role for two reasons. (1) Within the currently accepted model of human breast cancer evolution, these lesions are still viewed as successive steps in a linear progression model, ultimately leading to invasive breast carcinoma. (2) Some of these lesions may pose considerable diagnostic difficulties with high interobserver inconsistencies. These data highlight deficiencies in our understanding of the biology of the lesions in question. A body of sound new data clearly indicates that usual ductal hyperplasia and atypical ductal hyperplasia are not related to each other but are distinct lesions.