TITLE:
Atypical Ductal Hyperplasia of the Breast: Management of a Clinical Case at the IBN SINA Hospital Centre with Literature Review
AUTHORS:
Jean Alfred M’bongo, Yacir El Alami, Wilfried Loïc Tatsipie Meukem, Saissi Ananas, Fouad Tijami, Hanchi El Zaki, Hachi Hafid
KEYWORDS:
Atypical Ductal Hyperplasia, Management
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.8,
August
19,
2019
ABSTRACT: Objective: To report a case of difficulties in the management of atypical ductal
hyperplasia (ADH). Presentation of the case: Mrs. G, 50 years old, is consulting following the discovery at
autopalpation of a lesion on her left breast. In its history: radical
mastectomy Right Patey in 2004 for ductal carcinoma Infiltrant associated with
carcinoma in situ; 2 N+ /14; Positive
hormone receptors. Adjuvant treatment performed: chemotherapy, radiotherapy and
hormone therapy. Summary of the clinical case: Left breast examination: Superior External Quadrant
nodule 5 cm × 4, mobile, hard, without inflammatory signs, there is no palpable
lymph node. The surgical scar of the right breast is without particularity.
Mammography and left breast ultrasound show an ACR4 lesion according to BIRADS.
Microbiopsy: intradural papillomatous lesion requiring verification of the myoepithelial layer
(P63 and CK5/6). Immunohistochemistry: atypical ductal hyperplasia (ADH) with
no sign of transformation. Normal CA15-3 dosage. Treatment: broad surgical
removal of the lesion. Analysis of the part shows a lesion with all the
criteria of an HCA measuring 2 mm in its largest axis. The postoperative consequences
are simple. Conclusion: The management of atypical hyperplasia is not consensual and is often
undervalued. The type of lesion characterizing HCA is decisive for therapeutic
orientation.