Abstract
The purpose of this study was to evaluate the clinicopathological characteristics and most appropriate treatment for cases of atypical ductal hyperplasia（ADH）of the breast diagnosed by stereotactic vacuum―assisted breast biopsy（ST―VAB）. We reviewed the medical records of ７０ patients with ADH among１，１５３patients who underwent ST―VAB between２００３and ２０１１ in our hospital. All of the patients were women rangin age from３１ to ７９ years（mean age ４８．７ years）. The chief complaints, clinical course, mammography findings, and final or clinical diagnosis were studied. Sixty―three patients visited our hospital for further examinations after breast cancer screening. Six patients were examined for incidental findings during follow―up examinations for other reasons and１patient was examined because of abnormal nipple discharge. In all cases, mammography findings showed only calcifications. Among the ７０ cases, ５０ were classified as category ３, １９ as category ４, and１as category ５. In１７ cases, sequential excision or resection revealed breast cancer. There were１４cases of non―comedo―type DCIS, ２ cases of comedo―type DCIS, and １ invasive ductal carcinoma（invasive luminal type, ４ mm in size, no lymph node metastasis）. Benign lesions were found by excision in ２ patients, and ５３ patients were judged to have non―malignant lesions because of no change in clinical manifestations or imaging findings（median observation period ２６ months）. From these findings, we conclude that such atypical cases that require long―term follow―up would be found at a uniform rate once mammographic breast screening has become widespread. If malignancy is found in some patients during the follow―up period, it will be low―grade DCIS if US examination has been negative for malignancy. Therefore we will be able to follow such ADH cases using breast imaging without additional excision.
