Risks, Management of Atypical Hyperplasia of Breast Discussed
Considerations for women with atypical hyperplasia include screening, chemoprevention
WEDNESDAY, Dec. 31, 2014 (HealthDay News) -- Atypical hyperplasia is associated with increased breast cancer risk, and consequently, women should be educated regarding their risk of developing breast cancer and the potential risk reduction associated with chemoprevention, according to a special report published in the Jan. 1 issue of the New England Journal of Medicine.
Lynn C. Hartmann, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues describe risk assessment and management options for women with atypical hyperplasia of the breast, which has importance as a predictor of future breast cancer.
The researchers note that atypical hyperplasia confers an absolute risk of later breast cancer of 30 percent at 25 years of follow-up. For women with atypical hyperplasia, commonly used risk prediction models do not provide accurate risk assessment. Guidelines for high-risk women should be updated to include those with atypical hyperplasia, giving consideration to screening magnetic resonance imaging as well as mammography. For women with atypical hyperplasia, randomized controlled trials have shown the effectiveness of pharmacologic risk reduction, but few women use chemopreventive agents. Education relating to chemoprevention should include the absolute risk of breast cancer, anticipated risk reduction, and risks of side effects. For women with atypical hyperplasia, the risk of death from breast cancer should be considered in relation to the risk of death from other causes.
"Additional research is needed to advance the understanding and management of atypical hyperplasia," the authors write.