atypical ductal hyperplasia

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.

Pathology

Atypical ductal hyperplasia is a lesion with a lot of malignant potential. It lacks the strict criteria for ductal carcinoma in situ. A lesion which is qualitatively similar to DCIS yet quantitatively is inadequate (< 2 ducts involved) is termed as atypical ductal hyperplasia .

Treatment and prognosis

ADH 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 DCIS). Tamoxifen may be used as a chemopreventative agent.

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