Atypical hyperplasia's link to breast cancer 'more serious' than thought

January 13, 2015 | by Nicole White

Doctors have long known that women with a precancerous condition called atypical hyperplasia have an elevated risk of breast cancer. Now a new study has found that the risk is more serious than previously thought.

atypical hyperplasia New research has found that women with atypical hyperplasia have up to a 30 percent risk of developing breast cancer in their lifetime.  This is a higher risk than physicians had thought was linked to atypical hyperplasia. Researchers hope the findings will lead to more thorough screening options, such as MRI (shown), for women facing this increased risk.

Hyperplasia itself is an overgrowth of cells; atypical hyperplasia is an overgrowth in a distorted pattern. The condition is common, amounting to about 10 percent of the more than 1 million breast biopsies with benign findings in the U.S. The commonness of the condition is one reason the new study is so concerning.

The breast cancer risk study, conducted by researchers from the Mayo Clinic and published this month in the New England Journal of Medicine, found that about 30 percent of women with atypical hyperplasia developed breast cancer within 25 years of the diagnosis.

“The news is atypical hyperplasia is much more serious than we have been taking it,” said Laura Kruper, a breast surgeon and head of breast surgery service at City of Hope, in a HealthDay article on the study.  “When you say a cumulative risk of 30 percent at 25 years, that is pretty serious. … We as a medical community need to pay more attention to this.”

The study offered insight on the extent of atypical hyperplasia's rink. In the study, researchers followed nearly 700 women with atypical hyperplasia between 1967 and 2001. After an average follow-up of more than 12 years, 143 women had developed breast cancer. The findings were validated with a separate group of women at Vanderbilt University. In both groups, about 30 percent of women with atypical hyperplasia developed breast cancer.

Women typically have about a 12 percent lifetime risk of developing cancer.

Researchers said they hope the results will trigger a review of breast cancer screening guidelines by the American Cancer Society, potentially allowing women with the condition to have more rigorous screening. In the HealthDay story, experts offered the following advice to women with atypical hyperplasia:

  • Discuss chemopreventive medicines with your physician. Tamoxifen and aromatase inhibitors may be prescribed to women with higher than average breast cancer risk.
  • Consider a regular screening MRI (magnetic resonance imaging) in addition to mammogram. This is a standard practice for women at very high risk for breast cancer, including those who have a BRCA1 or BRCA2 mutation. Currently, women with atypical hyperplasia are in an intermediate-risk group. However, yearly mammograms and MRI are suggested for women who have a lifetime breast cancer risk of 20 to 25 percent – which is why researchers hope atypical hyperplasia as a more serious indicator of breast cancer risk will be reconsidered.

Learn more about breast cancer treatment and breast cancer research at City of Hope.

Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.

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