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==References==
{{Reflist|1}}
[[Category:Diagnosis]]
[[Category:Breast pathology]]
ed2659f4237af7617ec2d063bd72625326d8b91a17f5c0ec337534c11f51f690 librepath-flat-epithelial-atypia.txt
{{ Infobox diagnosis
| Name = {{PAGENAME}}
| Image = Proliferative fibrocystic changes -- intermed mag.jpg
| Width =
| Caption = Proliferative fibrocystic changes (''florid epithelial hyperplasia'' together with ''fibrocystic breast changes''). [[H&E stain]].
| Synonyms = florid epithelial hyperplasia of the usual type, usual ductal hyperplasia, moderate epithelial hyperplasia
| Micro = breast glands with more than four cell layers above the basement membrane with irregular cell spacing (e.g. streaming), slit-like lumina (esp. at the periphery of the duct), no [[DCIS]]-like architecture (not [[cribriform]], not papillary, not micropapillary, not solid), no nuclear atypia - usually no [[...
| Subtypes =
| LMDDx = [[mild epithelial hyperplasia]], [[atypical ductal hyperplasia]], cribriform [[ductal carcinoma in situ]]
| Stains =
| IHC = ER "low" (see below), CK5 "high" (see below)
| EM =
| Molecular =
| IF =
| Gross =
| Grossing =
| Site = [[breast]]
| Assdx = [[fibrocystic breast changes]] (FEH + FCC = ''proliferative fibrocystic changes'')
| Syndromes =
| Clinicalhx = usually an incidental finding
| Signs =
| Symptoms =
| Prevalence = common
| Bloodwork =
| Rads =
| Endoscopy =
| Prognosis = benign, increased risk of [[breast cancer]]
| Other =
| ClinDDx =
| Tx =
}}
'''Florid epithelial hyperplasia''', abbreviated '''FEH''', is a common benign [[breast pathology]] finding that is associated with a mild increased risk of [[breast cancer]].
It is also known as '''florid epithelial hyperplasia of the usual type''' (abbreviated '''FEHUT''') and '''usual ductal hyperplasia''' (abbreviated '''UDH''').
Confusingly, it may be referred to as ''epithelial hyperplasia'', term that is best avoided, as it could lead to confusion with ''[[mild epithelial hyperplasia]]''.
'''Moderate epithelial hyperplasia''' redirects to this article, as it is usually lumped with FEH. '''Proliferative fibrocystic changes''' (abbreviated '''PFCC''') redirects to this article.
==General==
*Mild increased risk of malignancy ~ 1.5-2x.<ref>{{Ref PCPBoD8|542}}</ref>
*Has to be separated from ''[[mild epithelial hyperplasia]]''.
Note:
*''Moderate epithelial hyperplasia'' redirects to this section.
**It is generally not separated from FEH, as the prognosis is thought to be the same.
==Microscopic==
Features:<ref>{{Ref BP|159-160}}</ref>
*Breast glands with ''more than'' four cell layers above the basement membrane - '''key feature'''.
*Irregular cell spacing; streaming.
*Slit-like lumina, esp. at the periphery of the duct.
*No [[DCIS]]-like architecture (not [[cribriform]], not papillary, not micropapillary, not solid).
*No nuclear atypia - usually no [[nucleoli]].
Memory device ''CLEAN'':
*'''C'''ell spacing is irregular, '''L'''umina are slit-like, '''E'''xtent is less than 2 mm or 2 ducts, '''A'''rchitecture ''not'' DCIS-like, '''N'''uclear atypia ''not'' present.
DDx:
*[[Mild epithelial hyperplasia]].
*[[Atypical ductal hyperplasia]].
*Cribriform [[ductal carcinoma in situ]]
===Images===
<gallery>
Image: Proliferative fibrocystic changes -- low mag.jpg |PFCC - low mag.
Image: Proliferative fibrocystic changes -- intermed mag.jpg |PFCC - intermed. mag.
Image: Proliferative fibrocystic changes -- high mag.jpg |PFCC - high mag.
Image: Proliferative fibrocystic changes -- very high mag.jpg|PFCC - very high mag.
</gallery>
==IHC==
Features:<ref name=pmid19675450>{{Cite journal | last1 = Grin | first1 = A. | last2 = O'Malley | first2 = FP. | last3 = Mulligan | first3 = AM. | title = Cytokeratin 5 and estrogen receptor immunohistochemistry as a useful adjunct in identifying atypical papillary lesions on breast needle core biopsy. | journal = Am J...
*ER "low".
*CK5 "high".
Where:
*ER "high" = diffuse strong staining in >90% of cells.
*CK5 "high" = mosaic pattern of staining in >20% of cells
*CK5 "low" = absent or staining in <20% of cells.
Note:
*ADH/DCIS:
**ER "high"
**CK5 "low".
==Sign out==
<pre>
A. Left Breast (795 grams), Reduction Mammoplasty:
- Benign breast tissue with usual ductal hyperplasia and skin within normal limits.
B. Right Breast (685 grams), Reduction Mammoplasty:
- Benign breast tissue and skin within normal limits.