A 48-year-old woman undergoes screening mammography that reveals a 1.5 cm area of architectural distortion with no palpable mass. Stereotactic core biopsy shows atypical ductal hyperplasia. What is the recommended management?
- A Repeat core biopsy in 6 months
- B Start tamoxifen chemoprevention
- C Surgical excisional biopsy ✓
- D Total mastectomy on the affected side
Correct answer: C. Surgical excisional biopsy
Explanation
Atypical ductal hyperplasia on core biopsy carries a significant risk of upgrading to DCIS or invasive carcinoma (approximately 10-30%). Surgical excisional biopsy is recommended to exclude malignancy. Observation alone is inadequate. Chemoprevention may be considered for risk reduction but is not a substitute for diagnostic excision. Mastectomy is excessive for a premalignant lesion.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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