Atypical hyperplasia of the breast
The diagnosis of atypical hyperplasia of the breast carries the increased risk of later diagnosis of breast cancer. Women with atypical hyperplasia have a 400% chance of getting breast cancer as compared to women who do not have this condition. As a result, doctors typically recommend intensive and frequent breast cancer screening along with medications in order to lower the chances of developing breast cancer.
Definition & Facts
Atypical hyperplasia is a build up of unusual breast cells that often turn into breast cancer. It is a precancerous condition that impacts the cells within the breasts. Should these cells continue to divide and become abnormal, atypical hyperplasia can progress into non-invasive breast cancer, also known as carcinoma in situ or become invasive breast cancer in time.
Symptoms & Complaints
The causes of the condition are not clearly understood. The most that the medical profession knows clearly is that breast cells divide too rapidly in this condition. As they divide, they overproduce and stack up on top of each other. This causes their shapes to become deformed and the nature of the cells themselves to become altered and unhealthy. In the end, their appearance is totally changed, as is their shape, growth pattern, and size.
Finally, one of the two types of atypical hyperplasia develops from the rapid increase of smashed together and mutated cells:
- Atypical lobular hyperplasia creates unusual cells with the appearance of cells that resemble the breast lobules.
- Atypical ductal hyperplasia develops abnormal appearance cells which look much like the cells found in the breast ducts.
Diagnosis & Tests
Diagnosing atypical hyperplasia is difficult simply because it does not present any of its own symptoms or warning signs. It is commonly uncovered during a biopsy that is run to check out another suspicious problem or area that shows up on a mammogram or in the course of a routine clinical breast examination. During such a biopsy, the doctor removes some tissue samples and sends them out to a laboratory for analysis at the hands of a specialized pathologist. These samples are carefully looked at beneath a microscope. The pathologist then identifies any atypical hyperplasia should it be found in the sample.
Sometimes the doctor will want to more thoroughly evaluate the atypical hyperplasia and will subsequently recommend a surgical procedure to take out a bigger tissue sample to examine it for any presence or trace of breast cancer. It is also possible that receiving a concrete diagnosis of atypical hyperplasia will lead to having a surgical biopsy done (via either lumpectomy or local excision) in order to take out all of the tissue that is so afflicted. Pathologists consider the bigger tissue specimen and look for evidence of either in situ or invasive forms of breast cancer.
Treatment & Therapy
Typically atypical hyperplasia is treated by surgery in which the doctors attempt to take out the unusual cells and to carefully check for any invasive or in situ cancer that may be lurking in the same area. A more serious screening for breast cancer is commonly recommended at this point, along with prescriptions for lowering the chances of contracting breast cancer. This helps to ensure that any developing breast cancer is found early when treatments are more readily and effectively available.
Treatment options can include taking a regimen of proactive prophylactic breast cancer medications. There are selective estrogen receptor modulators like raloxifene or tamoxifen that can be taken for five years to lower the overall chances of coming down with breast cancer. Taking aromatase inhibitors like anastrozole and exemestane in order to lower the estrogen production within the female body is also an option.
Another treatment option would include avoiding menopausal hormone replacement therapy. Researchers have discovered that combining progestin and hormone therapy for treating menopausal symptoms raises the chances of developing cancer for postmenopausal women. Hormones can help breast cancers to actually grow and develop.
Participating in clinical studies and trials may also be an option. There are a number of new treatment testing clinical trials that offer hope through medications which are not yet generally available to members of the public. These may be effective in reducing the chances of contracting breast cancer from atypical hyperplasia.
Finally, mastectomy will lower the chances of developing breast cancer. Women who stand a very high chance of developing breast cancer may choose to undergo such a mastectomy to remove either both breasts or only one of them so that their odds of coming down with such cancer in the future are considerably lowered.
Prevention & Prophylaxis
- Self administered breast examinations are typically taught so that women may develop sufficient familiarity with breast abnormality to be aware of any breast changes that are unusual.
- Annual breast screening mammograms.
- Clinical breast examinations to be completed by the primary care physician every year.
- Breast screening MRIs to determine if any other risk factors like family history, denser breasts, or genetic predispositions to cancer are present.