Abstract
This review summarizes the literature from the last 5 years regarding atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), classic lobular carcinoma in situ (C-LCIS), and non-classic LCIS (NC-LCIS). ADH, ALH, and C-LCIS are well-established markers of increased breast cancer risk. Recent studies suggest the possibility of observation for select cases of ADH diagnosed on core biopsy; however, guidelines support routine excision. In contrast, accumulating data support observation for ALH and C-LCIS on core biopsy with radiographic–pathologic concordance. Data on the natural history of pure NC-LCIS remain limited; however, when NC-LCIS is diagnosed on core biopsy, routine excision is warranted. ALH and C-LCIS on core biopsy should be reviewed for concordance to determine the need for excision; independent of surgical excision, all warrant counseling regarding increased future breast cancer risk. Current guidelines support routine excision for ADH and NC-LCIS on core biopsy. The natural history of NC-LCIS remains poorly defined.
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