- By sahlhealth
- May 18, 2021
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Atypical hyperplasia is a precancerous condition that affects cells in the breast. Atypical hyperplasia describes an accumulation of abnormal cells in the breast.
Atypical hyperplasia isn't cancer, but it can be a forerunner to the development of breast cancer. Over the course of your lifetime, if the atypical hyperplasia cells keep dividing and become more abnormal, this can transition into noninvasive breast cancer (carcinoma in situ) or invasive breast cancer.
If you've been diagnosed with atypical hyperplasia, you have an increased risk of developing breast cancer in the future. For this reason, doctors often recommend intensive breast cancer screening and medications to reduce breast cancer risk.
Atypical hyperplasia usually doesn't cause any specific symptoms.
Atypical hyperplasia is usually discovered after a biopsy to evaluate a suspicious area found on a mammogram or during a clinical breast exam. During the biopsy, tissue samples are removed and sent for analysis by a specially trained doctor (pathologist). The tissue samples are examined under a microscope, and the pathologist identifies atypical hyperplasia, if it's present.
To further evaluate atypical hyperplasia, your doctor may recommend surgery to remove a larger sample of tissue to look for breast cancer. A diagnosis of atypical hyperplasia may lead to a surgical biopsy (wide local excision or lumpectomy) to remove all of the affected tissue. The pathologist looks at the larger specimen for evidence of in situ or invasive cancer.
Atypical hyperplasia is generally treated with surgery to remove the abnormal cells and to make sure no in situ or invasive cancer also is present in the area. Doctors often recommend more intensive screening for breast cancer and medications to reduce your breast cancer risk.
Follow-up tests to monitor for breast cancer
Your doctor may recommend you undergo tests to screen for breast cancer. This may increase the chance that breast cancer is detected early, when a cure is more likely. Talk about your breast cancer screening options with your doctor. Your options may include:
Self-exams for breast awareness in order to develop breast familiarity and to detect any unusual breast changes
Clinical breast exams by your health care provider annually
Screening mammograms annually
Screening breast MRI, depending on other risk factors, such as dense breasts, a strong family history or a genetic predisposition to breast cancer
Ways to reduce your risk of breast cancer
To reduce your risk of developing breast cancer, your doctor may recommend that you:
Take preventive medications. Treatment with a selective estrogen receptor modulator, such as tamoxifen or raloxifene (Evista), for five years may reduce the risk of breast cancer.
These drugs work by blocking estrogen from binding to estrogen receptors in breast tissue. Estrogen is thought to fuel the growth of some breast cancers.
Tamoxifen is the only drug approved for use in premenopausal women.
Another option for postmenopausal women may be aromatase inhibitors, such as exemestane (Aromasin) and anastrozole (Arimidex), which decrease production of estrogen in the body.
Avoid menopausal hormone therapy. Researchers have concluded that combination hormone therapy to treat symptoms of menopause — estrogen plus progestin — increases breast cancer risk in postmenopausal women. Many breast cancers depend on hormones for growth.
Participate in a clinical trial. Clinical trials test new treatments not yet available to the public at large that may prove helpful in reducing breast cancer risk associated with atypical hyperplasia. Ask your doctor if you're a candidate for any clinical trials.
Consider risk-reducing (prophylactic) mastectomy. For women at very high risk of breast cancer, risk-reducing mastectomy — surgery to remove one or both breasts — reduces the risk of developing breast cancer in the future.
You might be considered at very high risk of breast cancer if you have a genetic mutation in one of the breast cancer genes or you have a very strong family history of breast cancer that suggests a likelihood of having such a genetic mutation.
But this surgery isn't right for everyone. Discuss with your doctor the risks, benefits and limitations of this risk-reducing surgery in light of your personal circumstances.
If you have a strong family history of breast cancer, you might benefit from meeting with a genetic counselor to evaluate your risk of carrying a genetic mutation and the role of genetic testing in your situation.