If you’ve ever had a breast tissue biopsy and have been told by your doctor that you have “abnormal breast tissue” or you hear the term “atypical hyperplasia”, you might want to consider having another discussion. Atypical hyperplasia (AH) refers to a classification of breast tissue cells which resemble those of a tumor, and which are found in one percent of breast biopsies performed in the U.S. each year. And, while it isn’t necessarily something to worry about, it definitely should not be ignored. Although doctors have long considered women with this type of breast tissue to face an above-average risk of breast cancer, new findings indicate that AH is a definite red flag for the disease developing down the road. In fact, a report in last month’s issue of the New England Journal of Medicine says that women with AH face a 7 percent risk of developing a tumor within 5 years, a 13 percent risk after 10 years and a 30 percent risk after 25 years. Findings like these sound less than benign.
Some members of the medical community feel that this should change the manner in which women with AH are advised and treated. Specifically, they believe that these women should undergo more aggressive screenings over and above traditional mammograms, such as MRI, and consider preventative medications such as tamoxifen. According to American Cancer Society (ACS) guidelines, MRI is indicated for women who face a 20 to 25 percent lifetime risk of breast cancer. Those guidelines did not, however, pertain to women with atypical hyperplasia, says Dr. Lynn Hartmann of the Mayo Clinic in Rochester, Minnesota. The new research sheds a different light on an AH finding. Dr. Hartmann advises women who have had a breast biopsy and have been told they have “atypical benign” cells to contact their doctor and discuss options. She explained that, while ninety percent of the time this won’t indicate AH, “she might want to clarify it further.”
The ACS is also a proponent of preventative medications to reduce breast cancer risk. However, chief medical officer Dr. Otis Brawley says that many women opt out of taking these meds despite their proven ability to reduce cancer risk. He said, “We have a large number of women who are undergoing the surgical removal of both breasts to reduce their risk of breast cancer, yet we have a pill with very few side effects that can prevent cancer and people are passing it up.” Dr. Hartmann says that, even though research has shown low incidence of side effects, the possibility remains a concern for many women.
If you have any question about results of a breast biopsy, contact your doctor and get the facts. Only then can you make an informed decision about what’s best for you.