Clinical Edge

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Atypical Hyperplasia and Breast Ca Risk

What does type and extent of AH tell us?

The extent of atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH) did not significantly contribute to breast cancer risk in a study of women with breast cancer and prior benign breast biopsy findings (n=488) who were matched to women with prior benign biopsy findings who were free from breast cancer (n=1,907). Study results determined:

• Among women with ADH, the interrelation between the extent of atypia and breast cancer risk was not significant (OR=3.5, for 1 or 2 foci; OR=2.7, for ≥3 foci)

• Similarly, although the risk with ALH was higher for those with ≥3 foci than for those with <3 foci, the difference was not statistically significant (OR=5.2, for 1 or 2 foci; OR=8.0 for ≥3 foci).

• Lack of a significant dose-response relation between the extent and type of atypia and breast cancer risk suggests it would be premature to use the extent of atypia to influence management decisions for women with ADH or ALH.

Citation: Collins LC, Aroner SA, Connolly JL, Colditz GA, Schnitt SJ, Tamimi RM. Breast cancer risk by extent and type of atypical hyperplasia: an update from the Nurses’ Health Studies. [Published online ahead of print November 13, 2015]. Cancer doi: 10.1002/cncr.29775.