For patients with atypical ductal hyperplasia, atypical lobular hyperplasia, or LCIS, what is the most appropriate treatment approach?

The most appropriate treatment approach for patients with atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), or lobular carcinoma in situ (LCIS) is resection of the lesion.

These conditions are considered markers of increased breast cancer risk rather than cancer themselves. Resection of the lesion provides a definitive diagnosis and helps rule out the presence of more extensive disease. Additionally, it allows for the careful assessment of the tissue for any unsuspected invasive cancer, which can be particularly important given the associated risk factors.

Mastectomy is generally not indicated simply for the presence of atypical hyperplasia or LCIS, as these findings do not usually merit such a radical approach. Observation may be appropriate in certain low-risk cases, but being proactive and removing the lesions often provides the best balance between minimizing risk and addressing any potential malignancy. Hormonal therapy is also an option in some scenarios related to risk reduction, but it is not typically the first-line treatment for these lesions without taking steps to remove them.