Risk of breast cancer associated with a diagnosis of atypical ductal hyperplasia may be lower than previously reported

MedicalResearch.com Interview with:
Tehillah S. Menes, MD

Department of Surgery
Tel Aviv-Sourasky Medical Center
Tel Aviv, Israel

MedicalResearch.com: What is the background for this study?

Response: Atypical ductal hyperplasia (ADH) is a known risk factor for breast cancer. The diagnosis is made by a biopsy showing a uniform proliferation of cells lining the ducts of the breast. These cells have monomorphic round nuclei and characteristically fill only part of the involved duct. Women diagnosed with ADH are recommended to undergo increased surveillance and offered chemoprevention (i.e. Tamoxifen) for risk reduction.
Most studies reporting on the risk of subsequent breast cancer in women with ADH were done prior to the wide use of screening mammography and percutaneous needle biopsy. Our study examined 10-year risk of invasive breast cancer in women diagnosed with ADH (by needle biopsy or excisional biopsy), using data collected by the Breast Cancer Surveillance Consortium (BCSC).

MedicalResearch.com: What are the main findings?

Response: We found lower 10-year rates of breast cancer than previously reported. The rates were even lower when atypical ductal hyperplasia was diagnosed on a needle biopsy, suggesting that current imaging and biopsy technology detect very small foci of ADH that carry lower risks.

MedicalResearch.com: What should readers take away from your report?

Response: The risk associated with a diagnosis of atypical ductal hyperplasia appears to be lower than previously reported. As this risk is modified by other risk factors, prior to recommending increased surveillance and risk modifying strategies, one should try to better quantify this risk using risk calculators developed from contemporaneous data such as the Breast Cancer Surveillance Consortium’s calculator (https://tools.bcsc-scc.org/bc5yearrisk/calculator.htm).

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: With the increased use of tomosynthesis, studies are needed to examine rates of  atypical ductal hyperplasia detection by tomosynthesis and the associated breast cancer risk.

MedicalResearch.com: Is there anything else you would like to add?

Response: This study examined the 10-year risk of invasive breast cancer in women diagnosed with ADH. This risk should not be confused with the risk of upgrade to breast cancer when ADH is diagnosed on a needle biopsy. Women that were upgraded to breast cancer when surgical biopsy was performed were not included in this study.

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