Atypical hyperplastic lesions of the female breast. A long-term follow-up study

TLDR

The study examined 10,542 breast biopsy specimens collected between 1950 and 1968 and achieved 90 % follow‑up over 17 years. Atypical ductal and lobular hyperplasia were identified in 3.6 % of these biopsies and were associated with a 4–5‑fold increased risk of invasive breast cancer, a risk that rises to 8–10‑fold with a family history of breast cancer and is roughly half that of carcinoma in situ.

Abstract

A total of 10,542 breast biopsy specimens obtained between 1950 and 1968 were studied. Examples of atypical "ductal" (ADH) and atypical lobular hyperplasia (ALH), defined as having only some features of carcinoma in situ (CIS), were diagnosed in 3.6% of these specimens. In the same series, CIS was diagnosed in 1.7% of biopsy specimens excluding those with invasive cancer. The subsequent risk of invasive breast carcinoma after ALH or ADH was 4–5 times that of the general population. Follow-up was 90% successful and extended 17 years after biopsy. History of breast cancer in a mother, sister, or daughter doubled the risk of subsequent invasive carcinoma development (to 8 times for ALH and 10 times for ADH). The authors conclude that among the epithelial hyperplastic lesions of the human breast, a minority may be recognized by their resemblance to CIS which have a clinically significant elevation of subsequent breast cancer risk. This risk is one-half that of CIS.