Atypical Ductal Hyperplasia of the Breast
Atypical ductal hyperplasia (ADH) is a precancerous breast condition that occurs when abnormal cells build up in the lining of the ducts that carry milk from the milk-producing glands (lobules) to the nipple. Although the abnormal cells share some characteristics of ductal carcinoma in situ (stage 0 breast cancer) in terms of appearance and growth patterns, ADH is a benign condition. However, because it is a marker for the future development of breast cancer, it should be periodically monitored by a breast cancer specialist.
The multidisciplinary team in Tampa General Hospital’s Cancer Institute and Breast Cancer Center diagnoses and treats all stages of breast cancer every day. In many cases, we can provide same-day tests and treatments ranging from core needle biopsies to minimally invasive breast interventions and excisions performed on an outpatient basis.
What Causes Atypical Ductal Hyperplasia?
For reasons that are not yet fully understood, breast cells sometimes grow in a disorganized manner and create a marker lesion, such as atypical ductal hyperplasia. Scientists have confirmed that the same microenvironment can—but not necessarily will—lead to the development of cancer.
What Are the Symptoms of Atypical Ductal Hyperplasia
Atypical ductal hyperplasia does not produce distinctive symptoms. Usually, the condition is detected during a routine mammogram or breast examination performed for an unrelated reason.
Atypical Ductal Hyperplasia Diagnosis
If ADH is suspected based on the results of an imaging scan or breast exam, a physician will typically order a biopsy to obtain a sample of the abnormal cells for microscopic evaluation by a pathologist. One option that is frequently used to diagnose atypical ductal hyperplasia is a stereotactic core needle biopsy. During this nonsurgical outpatient procedure, a physician numbs the breast area, then uses a fine needle guided by mammography to collect the cell sample. If a core biopsy reveals ADH, the physician may recommend an excisional biopsy to collect more tissue and rule out any associated cancer.
Atypical Ductal Hyperplasia Treatment
If cancer is ruled out based on the results of an excisional biopsy, the next steps involve breast surveillance and breast cancer risk-reduction strategies. Usually, a follow-up mammogram and breast exam are performed within six months after ADH is diagnosed. From there, most women resume their yearly mammograms. In some cases, a physician may also order an annual magnetic resonance imaging (MRI) scan of the breast.
Over time, a pathologist may label ADH as breast cancer if:
- Abnormal cells encroach on the space within a milk duct and cause the duct to expand beyond a certain threshold
- Two adjacent milk ducts are found to contain ADH
Benefit From World-Class Care at TGH
At TGH, we develop an appropriate surveillance program for each patient who is diagnosed with atypical ductal hyperplasia. This may include a customized combination of high-risk screening, risk-reducing strategies and lifestyle modifications to help reduce the patient’s overall breast cancer risk. If would like to talk with an expert on our team, contact us at (800) 844-4554 to request an appointment.