Keywords
Benign ductal hyperplasia; Atypical ductal hyperplasia; Ductal carcinoma in situ; Benign; Malignant; Prognosis
Abstract
The diagnosis of pre-cancerous breast lesions is important to evaluate the risk of recurrence and progression to invasive carcinomas. In this report, we present a 35-year-old female with suspicious microcalcification foci consistent with atypical ductal hyperplasia, but short of the qualifying 2 mm size of low-grade ductal carcinoma in situ. We used high molecular weight cytokeratin (HMW-CK- 903) as a marker to further analyze the lesion. A final diagnosis of two small foci of low-grade DCIS in the background of ADH was rendered. In challenging cases, like our case here, the use of such markers can be useful to reach accurate diagnosis and guide management plan. This is especially true when the patient is pregnant, and the lesion is borderline on size for the arbitrary limit of 2 mm, which determines the upgrade of atypical ductal hyperplasia to low-grade ductal carcinoma in situ. After full resection of the lesion, the patient elected not to have post-operative radiation therapy and subsequently had no recurrence at 7 years follow-up. In this manuscript, we review the literature on the difference between, benign ductal hyperplasia, atypical ductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma. We also discuss the importance of a proper diagnosis of pre-cancerous lesions, and how different treatments can be approached during pregnancy.
Citation
White M, Kaur T, Berry F, DiTommaso N, Taylor C, et al. (2020) Can High Molecular Weight Cytokeratin 903 Differentiate Benign Usual Breast Ductal Hyperplasia from Atypical Ductal Hyperplasia and Ductal Carcinoma in Situ? Report of a Case and Brief Review of the Literature. JSM Clin Cytol Pathol 2(3): 4.