Atypical Ductal Hyperplasia (ADH)

Atypical ductal hyperplasia (ADH) is a high-risk breast lesion with abnormal cell growth in the milk ducts. It is not cancer, but it can increase lifetime breast cancer risk and may be associated with nearby cancer that was not captured in the original biopsy.

At The Medical Group of New Jersey, we guide patients through the next steps, often including surgical excision, so the diagnosis is fully clarified and future risk is addressed proactively.

Symptom Onset & Initial Evaluation

ADH usually causes no symptoms and is most often found after:

• Abnormal screening mammography (often calcifications)
• Biopsy of a suspicious area

Your surgeon will review imaging findings, biopsy results, personal and family history, and overall risk factors.

Diagnosis

Diagnostic testing usually begins with:

• Core needle biopsy showing ADH
• A careful review for imaging-pathology concordance (whether the biopsy findings adequately explain what was seen on imaging)

Treatment & Ongoing Management

Management commonly includes:

• Surgical excision to ensure there is no associated DCIS or invasive cancer nearby
• If excision confirms ADH only, risk management may include:
  • Enhanced screening (sometimes alternating mammogram and MRI in higher-risk patients)
  • Lifestyle and risk-reduction counseling
  • Medication options (chemoprevention) are discussed with specialists when indicated

Follow-Up Care

Follow-up is individualized based on final pathology and overall risk profile, with long-term surveillance planning and coordination of preventive care.