Atypical lobular hyperplasia has higher breast Ca risk than ductal.(Gynecology)

SAN ANTONIO -- All women with atypical hyperplasia in a benign breast biopsy are at significantly increased risk of developing breast cancer, but the magnitude of risk is greater when the pathology involves atypical lobular hyperplasia than it is with atypical ductal hyperplasia, according to data from the Nurses' Health Study.

Only about 60% of the breast cancers that develop in women with either atypical lobular hyperplasia or atypical ductal hyperplasia occur in the ipsilateral breast. For this reason, both types of atypical hyperplasia are best regarded for purposes of clinical management as markers of a generalized bilateral increase in breast cancer risk, Dr. Laura C. Collins said at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.

She reported on 2,016 participants in the Nurses' Health Study who had a benign breast biopsy; 395 of them subsequently developed breast cancer. The 1,621 controls were matched to the cancer patients by age and year of their benign breast biopsy.

Of the women with atypical hyperplasia in a benign breast biopsy, 75 went on to develop breast cancer. That translated into an adjusted 3.93-fold greater risk of developing the malignancy for women with atypical hyperplasia compared with those who had a benign breast biopsy showing only nonproliferative changes, said Dr. Collins, a pathologist at Beth Israel Deaconess Medical Center and Harvard Medical School, Boston.

The adjusted odds ratio for developing breast cancer was 2.76 for ...