Guest Author - Dr. Denise Howard
Atypical hyperplasia is a condition where the cells are undergoing changes that are likely to develop into cancer over time. In the breast, these changes can occur in the ducts or the breast lobes. If the changes occur in the epithelial cells of the ducts, it is called Atypical Ductal Hyperplasia. Atypical Lobular Hyperplasia describes change in the epithelial cells of the breast lobes. The lesions have features similar to carcinoma in-situ and can be multi-focal lesions.
These conditions are of grave concern because of the associated risk of breast cancer. A woman with either of these conditions has a 3.7-5.3 times increased risk of developing cancer compared to normal. The cumulative lifetime risk of developing breast cancer over 30 years is close to 35%. Even more frustrating is the fact that the cancer can develop in a location distal from the hyperplastic lesion, even in the other breast.
Given this known increased risk of cancer, more frequent surveillance is required. In addition other preventative factors can be considered. Yearly mammogram and twice yearly breast examination are suggested. The doctor’s recommendations may also include a regular breast ultrasound. Of course any suspicious finding should be immediately biopsied or excised.
Women with this condition should avoid hormone replacement therapy and birth control pills. Other preventative measures maybe recommended and is dependent on family history, personal history, and the presence of other risk factors for breast cancer. Medications are available to reduce the chance of the developing breast cancer. These include selective estrogen receptor modulators such as tamoxifen and raloxifene or aromatase inhibitors. In depth counseling with an experienced health care provider is high recommended before electing to use such medications.
Other breast disorders that can be found but are not associated with an increased risk of breast cancer are listed below.
Lipoma: a mass composed of mature fat cells.
Fat necrosis: an area of liquefied fat that can result from trauma, surgery or other medical problems
Galactocele: cystic fluid collection that results from an obstructed milk duct.
Hamartoma: a mass containing glandular, adipose and fibrous tissue
Adenoma: benign epithleial cell tumor.
There are a number of breast problems that can result in a palpable mass or an abnormal finding on imaging studies. The majority are benign and do not indicate an increased risk of developing breast cancer. These signs should however initiate further evaluation to confirm the cause since early breast cancer detection is the key to cure.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!