The ducts in your breast are lined with two layers of cells. Ductal hyperplasia refers to having more than two layers of cells. With usual ductal hyperplasia, these extra cells look normal.
Atypical ductal hyperplasia ADH is the term used for a benign lesion of the breast that indicates an increased risk of breast cancer. The name of the entity is descriptive of the lesion; ADH is characterized by cellular proliferation hyperplasia within one or two breast ducts and histomorphologic architectural abnormalities, i. In the context of a core needle biopsyADH is considered an indication for a breast lumpectomy, also known as a surgical excisional biopsy, to exclude the presence of breast cancer.
In order for cells removed during a biopsy to be examined, they must be put on a slide, stained, and then looked at under a microscope. Cells are judged based on a number of criteria, including the size and color of the nucleus the center of the cell that contains DNAthe appearance of the other structures in the cytoplasm the area between the nucleus and the outer wall of the celland the overall size of the cell itself. For centuries, pathologists physicians who identify diseases by studying cells and tissues under a microscope have been trying to predict how cells will behave based on how they appear.
Metrics details. Atypical ductal hyperplasia ADH is a common diagnosis in the mammographic era and a significant clinical problem with wide variation in diagnosis and treatment. After a diagnosis of ADH on biopsy a proportion are upgraded to carcinoma upon excision; however, the remainder of patients are overtreated. While ADH is considered a non-obligate precursor of invasive carcinoma, the molecular taxonomy remains unknown.
With atypical ductal hyperplasia ADHthere are more cells than usual in the lining of the breast duct, the tube that carries milk from the lobules milk sacs to the nipple. These cells share some, but not all, of the features of low-grade ductal carcinoma in situ DCISboth in terms of growth patterns and appearance. ADH is a benign breast condition linked to a moderate increase in breast cancer risk.
Atypical ductal hyperplasia ADH is a breast lesion associated with a four- to five-fold increase in the risk of breast cancer. ADH is primarily found using mammography and identified on core needle biopsy. Despite multiple passes of the lesion during biopsy, only portions of the lesions are sampled.
Atypical ductal hyperplasia ADH is when a breast has more than the normal two layers of cells in the milk ducts and those additional cells are abnormal in size, shape, appearance, and growth pattern. Atypical ductal hyperplasia is diagnosed with a biopsy; it cannot be detected via a breast exam or imaging. If found, atypical ductal hyperplasia will require close monitoring.
Atypical ductal hyperplasia ADH is not a form of breast cancer. Rather, it is a marker for women who may have a risk factor for developing breast cancer in the future. If you have a biopsy that shows atypical ductal hyperplasia in one of your breasts, your doctor will want to follow your breast health very carefully.
Ductal breast cancer is thought to begin with abnormal tissue growth in a breast duct. Normal breast duct is shown. An overgrowth of normal cells may develop in the breast duct hyperplasia.
If you've been diagnosed with ADH, you'll need expert advice on the treatment and follow-up that's best for you. Normally each duct is lined with an even layer of cells, but in the area affected by ADH there can be many layers. However, this change is not cancerous, and ADH is not a form of breast cancer. The illustrations below show a normal duct and a duct that's developed extra cells.