Surgical Pathology Criteria

Atypical Ductal Hyperplasia of the Breast

Differential Diagnosis

Low Grade DCIS vs. Atypical Ductal Hyperplasia (ADH)

Low Grade Ductal Carcinoma In Situ and Atypical Ductal Hyperplasia Columnar Cell Change / Hyperplasia
Architectural complexity manifested by a) partial or complete filling of ducts or b) arcades or micropapillary formations Essentially a flat lesion, lacks architectural complexity
Low grade nuclear atypia present (except some cases of ADH that have architectural complexity) Cytologically bland

Low Grade Ductal Carcinoma In Situ and Atypical Ductal Hyperplasia Flat Epithelial Atypia
Architectural complexity manifested by a) partial or complete filling of ducts or b) arcades or micropapillary formations Lacks architectural complexity
All three have low grade nuclear atypia, except for some cases of ADH, which must have architectural complexity

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