Some benign (non-cancerous) breast conditions are associated with an increased risk of developing breast cancer in the future. These conditions are diagnosed on a biopsy and often require surgery and follow-up monitoring over time (surveillance).
Which breast conditions increase breast cancer risk?
High risk breast lesions include:
- Atypical Hyperplasia
In atypical hyperplasia, breast cells become abnormal in number, size, shape, growth pattern and appearance. These abnormal cells may accumulate and evolve into cancer. Atypical hyperplasia can occur in the lining of either the breast ducts or the breast lobules:- Atypical Ductal Hyperplasia (ADH) (abnormal cells in the breast ducts)
- Atypical Lobular Hyperplasia (ALH) (abnormal cells in the breast lobules)
- Lobular Carcinoma In Situ (LCIS)
In LCIS, cells that resemble cancer cells grow inside the breast lobules. Usually, these abnormal cells stay within the walls of the lobule. As such, LCIS rarely develops into invasive cancer. Occasionally however, the abnormal cells migrate through the lobule wall to invade surrounding breast tissue.- Pleomorphic LCIS (a form of LCIS that carries a higher risk of progression to invasive breast cancer)
- Radial Scar (Complex Sclerosing Lesion)
Radial scars are growths containing ducts and lobules with unusual characteristics such as cysts, benign hyperplasia and/or atypical hyperplasia. The larger the abnormal area, the more likely it is to contain atypical hyperplasia. Radial scars may grow large enough to be detected via mammography (the lesion often mimics cancer on imaging) or felt on physical breast examination (if very large).
What type of surgery will I need?
Excisional biopsy will usually be recommended to remove the lesion. The tissue will be analysed under a microscope to exclude additional diagnoses requiring further treatment [such as Ductal Carcinoma In Situ (DCIS) or invasive breast cancer].
What follow-up will I need?
Follow-up will depend on the result of your excisional biopsy. Dr Lancashire will take you through any further steps that may be required, including scans you many need in the future.
