Atypical Hyperplasia and Breast-Cancer Risk

By

Annual breast exams and mammograms are an important screening tool for detecting breast cancer. Mammograms can show an abnormality in the breast. A biopsy may be needed to take a look at the cells in the area of concern. Based on the biopsy, additional tests may be needed. About 10 percent of benign breast biopsies uncover a condition called atypical hyperplasia.

Atypical hyperplasia of the breast is a precancerous condition. When breast cells are examined under a microscope, they appear to be growing out of control (hyperplasia) and forming abnormal clusters (atypical). It's thought that because of this abnormal process, these cells are more likely to develop into cancerous tumors in the future.

Mayo Clinic researchers have discovered that women with atypical hyperplasia of the breast are at higher risk for developing breast cancer. This may change screening and prevention recommendations for women identified to have atypical hyperplasia.

A team of researchers followed 698 women with atypical hyperplasia who had biopsies at the Mayo Clinic between 1967 and 2001. The findings were validated by researchers at Vanderbilt University. Both groups found that 25 to 30 percent of women diagnosed with atypical hyperplasia had developed breast cancer over a period of 25 years.

The study looked further into an individual's risk by analyzing each patient's pathology specimen. It found that as the extent of the atypia increased, the risk also increased. For example, women with three or more atypical hyperplasia areas (either in the ductal or lobular areas of the breast) had a higher risk of developing breast cancer compared to those with one atypical area.

Based on these results, the researchers recommend that women who have atypical hyperplasia have the option to be screened with MRI in addition to mammography because of their increased risk of cancer.

In addition, it's important that they consider anti-estrogen medications such as tamoxifen which have been shown to lower their risk by at least 50 percent. Results of the study appear in a special report on breast cancer in the New England Journal of Medicine.

Have you been told you have atypical hyperplasia? Please share your thoughts on this topic.

Sheryl M. Ness, RN, is a nurse educator for the Cancer Education Program with the Mayo Clinic, in Rochester, Minn. Reprinted with permission from www.mayoclinic.org. Follow Sheryl on Twitter @SherylNess1.