European Institute of Oncology, Breast Imaging Unit, Via G. Ripamonti, 435, 20141, Milano, Italy.
Postgraduate School of Radiology, Università degli Studi di Milano, Milan, Via Festa del Perdono 7, Milan, Italy.
Breast. 2018 Feb;37:1-5. doi: 10.1016/j.breast.2017.10.003. Epub 2017 Oct 12.
Atypical ductal hyperplasia (ADH) is a high-risk benign lesion found in approximately 1-10% of breast biopsies and associated with a variable incidence of carcinoma after surgical excision. The main goal of our study is to present our experience in the management and long-term follow-up of 71 patients with ADH diagnosed on breast biopsy.
Results of 3808 breast biopsy specimens from 1 January 2000 to 31 December 2005 were analyzed to identify all biopsies which resulted in a diagnosis of ADH. The histopathological results of the 45 patients who underwent surgery were analyzed. Long-term follow-up for the remaining patients was carried out.
45 of 71 (63.4%) patients with histological diagnosis of ADH on breast biopsy underwent surgery. Definitive histological results revealed invasive carcinoma in 7 cases (15.6%), high grade Ductal Carcinoma in situ (DCIS) in 10 (22.2%) patients, Lobular Carcinoma in situ (LCIS) in 4 cases (8.9%) and benign findings in 24 cases (53.3%). 12 of 71 (16.9%) patients underwent only long term follow-up; one (8,3%) of these developed invasive breast carcinoma after 6 years.
Atypical ductal hyperplasia diagnosed on breast biopsy is associated with a relatively high incidence of invasive carcinoma and high grade ductal carcinoma in situ at the time of surgical excision. Certain radiological and cytological criteria can be used to help determine which patients should forgo surgery and be followed up with good results. Long term follow-up is always crucial for patients who have not undergone surgery.
非典型性导管增生（ADH）是一种高危良性病变，约占乳腺活检的 1-10%，在手术切除后与癌的发生率呈变量相关。我们的主要目的是介绍我们在管理和对 71 例经乳腺活检诊断为 ADH 患者的长期随访方面的经验。
对 2000 年 1 月 1 日至 2005 年 12 月 31 日的 3808 例乳腺活检标本的结果进行分析，以确定所有导致 ADH 诊断的活检。对 45 例接受手术的患者的组织病理学结果进行了分析。对其余患者进行了长期随访。
71 例乳腺活检组织学诊断为 ADH 的患者中，有 45 例（63.4%）接受了手术。明确的组织学结果显示，7 例（15.6%）有浸润性癌，10 例（22.2%）有高级别导管原位癌（DCIS），4 例（8.9%）有小叶原位癌（LCIS），24 例（53.3%）为良性发现。71 例患者中有 12 例（16.9%）仅接受了长期随访；其中 1 例（8.3%）在 6 年后发生浸润性乳腺癌。
乳腺活检诊断的非典型性导管增生在手术切除时与浸润性癌和高级别导管原位癌的发生率相对较高相关。某些放射学和细胞学标准可用于帮助确定哪些患者可以避免手术并取得良好的随访结果。对于未接受手术的患者，长期随访始终至关重要。
