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Review

Atypical hyperplasia of the breast: Clinical cases and management strategies

Suneela Vegunta, MD, Dawn M. Mussallem, DO, Aparna S. Kaur, MD, Sandhya Pruthi, MD and Christine L. Klassen, MD
Cleveland Clinic Journal of Medicine July 2023, 90 (7) 423-431; DOI: https://doi.org/10.3949/ccjm.90a.22098
Suneela Vegunta
Assistant Professor of Medicine; Vice-Chair, Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ
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  • For correspondence: [email protected]
Dawn M. Mussallem
Assistant Professor of Medicine; Consultant, Breast Diagnostic Clinic, Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL
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Aparna S. Kaur
Assistant Professor of Medicine; Consultant, Breast Diagnostic Clinic, Mayo Clinic, Rochester, MN
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Sandhya Pruthi
Professor of Medicine; Consultant, Breast Diagnostic Clinic, Mayo Clinic, Rochester, MN
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Christine L. Klassen
Assistant Professor of Medicine; Director, Breast Diagnostic Clinic, Mayo Clinic, Rochester, MN
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    TABLE 1

    Management of high-risk breast lesions

    High-risk breast lesionRate of upgrade to invasive breast cancerManagement after core needle biopsyUse of risk-reducing endocrine therapy
    Atypical ductal hyperplasia10% to > 30%14,15Observation if radiologic and pathologic findings are concordant or after excisional biopsyYes
    Atypical lobular hyperplasia0% to 67%17Observation if radiologic and pathologic findings are concordant or consider an excisional biopsyYes
    Flat epithelial atypia0% to 21%16Observation if radiologic and pathologic findings are concordant or consider an excisional biopsyAssess breast cancer risk factors and use available risk-assessment calculators (BCRAT or IBIS)
    Yes, if there is elevated risk
    • BCRAT = Breast Cancer Risk Assessment Tool; IBIS = International Breast Cancer Intervention Study

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Cleveland Clinic Journal of Medicine: 90 (7)
Cleveland Clinic Journal of Medicine
Vol. 90, Issue 7
1 Jul 2023
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Atypical hyperplasia of the breast: Clinical cases and management strategies
Suneela Vegunta, Dawn M. Mussallem, Aparna S. Kaur, Sandhya Pruthi, Christine L. Klassen
Cleveland Clinic Journal of Medicine Jul 2023, 90 (7) 423-431; DOI: 10.3949/ccjm.90a.22098

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Atypical hyperplasia of the breast: Clinical cases and management strategies
Suneela Vegunta, Dawn M. Mussallem, Aparna S. Kaur, Sandhya Pruthi, Christine L. Klassen
Cleveland Clinic Journal of Medicine Jul 2023, 90 (7) 423-431; DOI: 10.3949/ccjm.90a.22098
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