Breast Pathology and Cancer Diagnosis

Usual Epithelial Hyperplasia (UEH)

The Separation of epithelial proliferative lesions and differentiation between usual epithelial hyperplasia. And atypical ductal hyperplasia (ADH) is the most common problems encountered. Intra duct benign epithelial proliferation, Epithelial and myoepithelial cells proliferate together. Therefore mixed pattern seen on CK 5/6 or P63 immunostaining. In this condition Streaming pattern usually seen and Peripheral slit-like spaces within ducts is present, Cells are smaller in size, more crowded and overlapping than in atypical proliferations or carcinoma in Situ. Atypical hyperplasia is of three types Atypical Ductal Hyperplasia (ADH): Columnar Cell Change with atypia, Atypical Lobular Hyperplasia (ALH). ADH is important because it carries a 4-5 times relative risk of breast cancer at 10-15 yrs. post biopsy.  It causes difficulty to diagnostic pathologists - inconsistency in diagnosis is common. It lies closest morphologically to low grade DCIS - it is not a high grade lesion.