Atypical epithelial hyperplasia of the breast: state of the art

Expert Rev Anticancer Ther. 2016 Sep;16(9):943-53. doi: 10.1080/14737140.2016.1204916. Epub 2016 Jul 5.

Abstract

Introduction: Atypical epithelial hyperplasia (AEH) of the breast is considered benign histological lesions with breast cancer risk. This review focuses on clinical signification and management of AEH that remains controversial.

Areas covered: A review of published studies was performed using medline database. In this review, we fully describe the current evidence available. In particular, we describe 1) data from immunohistochemistry and molecular studies that suggest AEH is a precursor of breast cancer; 2) epidemiological studies demonstrate low rate of breast cancer in women with AEH; 3) surgical excision is necessary after diagnosis of AEH, such as lobular carcinoma in situ or atypical ductal hyperplasia, on core needle biopsy; 4) although current recommendations are evolving to fewer (if not no) excisions for flat epithelial with atypia and classic lobular neoplasia found on percutaneous biopsy (without radiologic indications for excision). Expert commentary: HEA management steel need prospective evidences, but recent retrospective data give some clue for less invasive management for some of HEA.

Keywords: Atypical ductal hyperplasia; atypical lobular hyperplasia; breast cancer; columnar cell lesions with atypia; core needle biopsy; lobular carcinoma in situ; lobular neoplasia; surgical excision.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Breast / pathology*
  • Breast / surgery
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology
  • Female
  • Humans
  • Hyperplasia / diagnosis
  • Hyperplasia / pathology
  • Immunohistochemistry
  • Precancerous Conditions / diagnosis*
  • Precancerous Conditions / pathology
  • Precancerous Conditions / surgery
  • Risk