A patient is found to have atypical lobular hyperplasia (ALH) after a core-needle biopsy. What is the next recommended procedure for this patient?

A patient is found to have atypical lobular hyperplasia (ALH) after a core-needle biopsy. What is the next recommended procedure for this patient?

• A. Lumpectomy
• B. Excisional biopsy
• C. Mastectomy
• D. Observation only

Answer: (B)

Atypical lobular hyperplasia (ALH) is a type of breast tissue change that is associated with an increased risk of breast cancer. When ALH is identified through a core-needle biopsy, the typical next step involves an excisional biopsy, which is a procedure to surgically remove a wider area of breast tissue surrounding the site of the abnormality. The excisional biopsy is important because it allows for complete assessment of the lesion. It provides not only confirmation of the diagnosis but also ensures that any adjacent areas of concern are evaluated. Additionally, excisional biopsy enables further examination of the tissue for other potential abnormalities, such as ductal carcinoma in situ (DCIS) or invasive cancer, which may not be detected in the initial core-needle biopsy sample. In contrast, while a lumpectomy (removal of the tumor with some surrounding tissue) and mastectomy (removal of one or both breasts) could be considered in the context of confirmed breast cancer, they are not the initial recommended procedures for a diagnosis of ALH. Observation alone is not advisable as it does not provide the necessary information or intervention for a condition that indicates a higher risk for cancer. Thus, excisional biopsy is the most appropriate next step to

Atypical lobular hyperplasia (ALH) is a type of breast tissue change that is associated with an increased risk of breast cancer. When ALH is identified through a core-needle biopsy, the typical next step involves an excisional biopsy, which is a procedure to surgically remove a wider area of breast tissue surrounding the site of the abnormality.

The excisional biopsy is important because it allows for complete assessment of the lesion. It provides not only confirmation of the diagnosis but also ensures that any adjacent areas of concern are evaluated. Additionally, excisional biopsy enables further examination of the tissue for other potential abnormalities, such as ductal carcinoma in situ (DCIS) or invasive cancer, which may not be detected in the initial core-needle biopsy sample.

In contrast, while a lumpectomy (removal of the tumor with some surrounding tissue) and mastectomy (removal of one or both breasts) could be considered in the context of confirmed breast cancer, they are not the initial recommended procedures for a diagnosis of ALH. Observation alone is not advisable as it does not provide the necessary information or intervention for a condition that indicates a higher risk for cancer. Thus, excisional biopsy is the most appropriate next step to