Objective: To report a case of difficulties in the management of a typical ductal\nhyperplasia (ADH). Presentation of the case: Mrs. G, 50 years old, is\nconsulting following the discovery at autopalpation of a lesion on her left\nbreast. In its history: radical mastectomy Right Patey in 2004 for ductal carcinoma\nInfiltrant associated with carcinoma in situ ; 2 N+ /14; Positive hormone\nreceptors. Adjuvant treatment performed: chemotherapy, radiotherapy\nand hormone therapy. Summary of the clinical case: Left breast examination:\nSuperior External Quadrant nodule 5 cm * 4, mobile, hard, without inflammatory\nsigns, there is no palpable lymph node. The surgical scar of the\nright breast is without particularity. Mammography and left breast ultrasound\nshow an ACR4 lesion according to BIRADS. Microbiopsy: intradural\npapillomatous lesion requiring verification of the myoepithelial layer (P63\nand CK5/6). Immunohistochemistry: atypical ductal hyperplasia (ADH) with\nno sign of transformation. Normal CA15-3 dosage. Treatment: broad surgical\nremoval of the lesion. Analysis of the part shows a lesion with all the criteria\nof an HCA measuring 2 mm in its largest axis. The postoperative consequences\nare simple. Conclusion: The management of atypical hyperplasia is\nnot consensual and is often undervalued. The type of lesion characterizing\nHCA is decisive for therapeutic orientation.
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