AIDEP stands for Atypical Intraductal Epithelial Proliferation. It's a breast lesion classified as "indeterminate" when detected through a core needle biopsy (CNB). This means the biopsy results aren't definitive enough to say for certain whether the lesion is benign (non-cancerous) or malignant (cancerous).
Understanding AIDEP
- Indeterminate Diagnosis: The key characteristic of AIDEP is its uncertain nature following a core needle biopsy. Further investigation is always necessary.
- Core Needle Biopsy (CNB): This procedure involves removing small tissue samples using a needle. While useful for initial assessment, it sometimes yields inconclusive results like AIDEP.
- Diagnostic Excision: Following an AIDEP diagnosis, a larger tissue sample is typically removed through a surgical procedure (excision) to obtain a more definitive diagnosis. The rate of upgrading an AIDEP diagnosis to a more serious finding after excision varies depending on the study.
- Relationship to Other Terms: AIDEP is often associated with or used interchangeably with terms like atypical ductal hyperplasia (ADH), particularly when found in core biopsies. The use of "AIDEP" is recommended for describing low-grade atypical ductal hyperplasia diagnosed on core biopsy.
Diagnostic Approaches and Management
- Vacuum-Assisted Biopsy (VAB): This technique removes larger tissue samples than a standard core needle biopsy, potentially providing a more conclusive diagnosis and minimizing the need for further surgery in some cases. It can be used to better characterize lesions initially identified as AIDEP on core biopsy.
- Vacuum-Assisted Excision (VAE): This non-surgical procedure removes a larger sample of breast tissue than a standard biopsy, potentially providing more complete information and avoiding the need for a separate surgical excision in certain situations. VAE and mammographic surveillance are proposed as alternatives to surgery for managing ductal atypias, including AIDEP/ADH.
- Microscopic Review: AIDEP cases often undergo microscopic review by pathologists to confirm the presence of atypia based on established criteria.
Significance and Implications
An AIDEP diagnosis requires further investigation to determine whether the lesion is benign or malignant. Various techniques such as VAB or VAE, along with surgical excision, are used to achieve a definitive diagnosis. The management strategy depends on individual circumstances and the findings of these additional assessments.
