Sharp F Malak MD,MPH, Presenter: Nothing to Disclose

Janice S Sung MD, Abstract Co-Author: Nothing to Disclose

Elizabeth A. Morris MD, Abstract Co-Author: Nothing to Disclose

Carol H. Lee MD, Abstract Co-Author: Nothing to Disclose

D. David Dershaw MD, Abstract Co-Author: Nothing to Disclose

To determine the incidence of breast cancer during 10 years of observation following the diagnosis of atypical ductal hyperplasia.

This study was IRB approved. Retrospective review identified 37 women in whom ADH was the final diagnosis following needle localized surgical excision of mammographically detected lesions in 1999 and 2000. The number and type of cancers diagnosed during 10 years of follow up were determined as well as the age at diagnosis, menopausal status, parity, hormonal use, family and personal history of breast cancer, and imaging features.

Of these 37 women, follow-up of at least five years was available in 25/37 (68%), which comprises the cohort of patients included in the analysis. The median period of follow-up was 9.8 years (mean, 9.0; range, 5.1 - 11.4) with 84% of patients having > 7 years of follow-up. Mean age at time of diagnosis of ADH was 53.0 ± 9.8 years (range 40 - 79). Two patients developed breast cancer during the 10 years of follow up, resulting in an overall cancer incidence of 8.0% (95% CI, 1.0-26.0). Both cancers developed in women with a personal history of breast cancer, and occurred in the breast contralateral to the original cancer. The two incident cancers were DCIS detected at 9.1 and 10.0 years in women who were premenopausal at the time of original ADH diagnosis. A personal history of breast cancer independent of age was not significantly associated with the development of breast cancer 25% (2/8) vs. 0% (0/17), p=0.09. However, patients with ADH and a history of premenopausal breast cancer were significantly more likely to development breast cancer over the study period than patients with either a personal history of postmenopausal breast cancer or in those without a personal history of breast cancer, 66% (2/3) vs. 0% (0/22), p=0.01.

Breast cancer incidence after ADH was 8%, was DCIS, developed at > 9 years and only in women with a personal history of breast cancer. No other women developed breast cancer.

Unlike other series, our experience suggests that ADH may be most significant in premenopausal women with a personal history of breast carcinoma and may be less significant in other women.

Malak, S, Sung, J, Morris, E, Lee, C, Dershaw, D, Outcome of Atypical Ductal Hyperplasia: A 10-year Follow-up Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006480.html