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Breast Cancer

Atypical duct hyperplasia

04/24/2008

Question:

I would have liked to have more information on treatment for atypical duct hyperplasia and the causes of this abnormality in the breast. Also the percentage who go on to develop cancer with this disease with and without convientional treatment.

Answer:

Ductal hyperplasia is caused by excessive growth of the ductal epithelium (lining cells).  When these cells lose their normal characteristics, they are referred to as atypical.  This is a precursor to invasive cancer. Atypical ductal hyperplasia (ADH) is associated with about a 5 fold increased risk of the development of breast cancer.  When it is diagnosed by needle biopsy, there is about a 20% chance of finding a cancer right next to the ADH, and complete excision should be performed.  Since women with ADH are at higher risk for breast cancer, they may choose to manage their risk by increased surveillance (clinical breast exams twice per year and annual mammograms as well as breast self-exam), by taking a medicine to lower their risk (Tamoxifen lowers the risk by about 50%) or by having preventive (prophylactic) mastectomy.

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Response by:

Doreen M Agnese, MD Doreen M Agnese, MD
Clinical Associate Professor of Surgery and Internal Medicine
College of Medicine
The Ohio State University