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. Other variable factors influence sampling and accuracy such that the presence of cancer may be underestimated by 10 to 45 percent. Currently, surgical removal is recommended for all ADH cases found on core needle biopsies to determine if the lesion is cancerous.

LEBANON, NH - 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. Other variable factors influence sampling and accuracy such that the presence of cancer may be underestimated by 10-45%. Currently, surgical removal is recommended for all ADH cases found on core needle biopsies to determine if the lesion is cancerous.

What is the background for this study? What are the main findings? Response: Image-guided biopsies that we perform based on suspicious findings on mammography can yield one of three pathology results: cancer, high-risk, or benign. Most high-risk breast lesions are noncancerous, but surgical excision is typically recommended because some high-risk lesions can be upgraded to cancer at surgery. Currently, there are no imaging or other features that reliably allow us to distinguish between high-risk lesions that warrant surgery from those that can be safely followed, which has led to unnecessary surgery of high-risk lesions that are not associated with cancer.