Diagnostic Management of the Atypical Hyperplasias: Core Biopsy Alone Versus Excisional Biopsy

  • Emily Siegel
  • Alice ChungEmail author


Atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH) are two indeterminate lesions found on breast core needle biopsy (CNB). These lesions have the potential to upstage to carcinoma on excisional biopsy. A number of studies have attempted to identify factors that may be associated with a low rate of upgrading to malignancy, thereby allowing conservative management to avoid unnecessary surgery. Patients with ADH on CNB continue to have a substantial risk of upgrade. In contrast, some patients with ALH on CNB with concordant pathologic, radiologic, and clinical information have a relatively low risk of upstaging on excision. Therefore, patients with ADH on CNB must be excised while a discussion of the risks and benefits are recommended for patients diagnosed with ALH.


Atypical ductal hyperplasia Atypical lobular hyperplasia Core needle biopsy Upstaging Carcinoma Concordance 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cedars-Sinai Medical CenterLos AngelesUSA

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