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

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Tables

  • 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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