When central or peripheral intraductal papilloma is co-diagnosed with atypical ductal hyperplasia (ADH) on core needle biopsy (CNB) or vacuum-assisted breast biopsy (VABB), the elevated histological finding changes the clinical picture and calls for an individualised management plan.

Clinical Scenario

This protocol addresses patients with central or peripheral intraductal papilloma in whom atypical ductal hyperplasia (ADH) has been identified by CNB or VABB. Because ADH carries distinct tissue-level implications, these patients are treated individually according to their specific conditions rather than under a uniform surveillance approach.

Treatment Approach

For intraductal papilloma with co-diagnosed ADH, the recommended first-choice intervention is an open surgical procedure. The full protocol specifies the indications, scope of resection, and the decision pathway that follows — including when follow-up monitoring is sufficient and when further surgical intervention is warranted.

Treatment Goal

Complete removal of the lesion, confirmed on imaging.

References

DOI: 10.1097/CM9.0000000000001533

The panel believes that patients diagnosed with central or peripheral intraductal papilloma with ADH by CNB/VABB should be treated individually according to their specific conditions.
Open surgical resection is the first choice for patients with ADH.
If the patient has a single lesion and imaging shows that it has been completely removed, follow-up monitoring can be carried out; open extended resection is recommended in cases of uncertain complete resection.

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Treatment of Intraductal Papilloma of Breast with Atypical Ductal Hyperplasia (ADH)

References