A 43-year-old female with a positive family history of breast cancer presents with bilateral increased density and glandular pattern on routine mammography. Core needle biopsy show... A 43-year-old female with a positive family history of breast cancer presents with bilateral increased density and glandular pattern on routine mammography. Core needle biopsy showed atypical ductal hyperplasia. What is the appropriate management?
Understand the Problem
The question presents a clinical scenario involving a 43-year-old female patient with a family history of breast cancer and atypical ductal hyperplasia (ADH) diagnosed via core needle biopsy. The question asks for the appropriate management of this patient's condition, with two options provided: wide surgical excision and simple mastectomy. This requires knowledge of breast cancer risk assessment and management guidelines for ADH.
Answer
Management includes close surveillance, possible MRI, risk reduction strategies, and potentially surgical excision to rule out malignancy.
Given the patient's age, family history, and biopsy results showing atypical ductal hyperplasia (ADH), the appropriate management would likely include close surveillance with regular mammograms and possibly MRI, risk reduction strategies such as lifestyle modifications or chemoprevention, and surgical excision in some cases to further evaluate the area and exclude co-existing malignancy.
Answer for screen readers
Given the patient's age, family history, and biopsy results showing atypical ductal hyperplasia (ADH), the appropriate management would likely include close surveillance with regular mammograms and possibly MRI, risk reduction strategies such as lifestyle modifications or chemoprevention, and surgical excision in some cases to further evaluate the area and exclude co-existing malignancy.
More Information
Atypical ductal hyperplasia (ADH) is a precancerous condition that increases the risk of developing breast cancer. Comprehensive management is essential to monitor and mitigate this risk effectively.
Tips
A common mistake is to underestimate the risk associated with ADH and not recommend appropriate follow-up or risk reduction strategies. It's also important to consider the patient's individual risk factors and preferences when determining the best course of action.
Sources
- Understanding Your Pathology Report: Atypical Hyperplasia (Breast) - cancer.org
- Atypical ductal hyperplasia: What it is and how it's treated - mdanderson.org
- Atypical Ductal Hyperplasia: Breast, Symptoms & Treatment - my.clevelandclinic.org
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