A report of a new study on breast cancer that was published in the New England Journal of Medicine have revealed that women who have atypical hyperplasia have a higher risk of developing breast cancer than previously assumed.
Atypical hyperplasia of the breast is actually a precancerous condition. When the breast cells were viewed under a microscope, it was seen that during that condition they were beginning to grow out of control (hyperplasia) and cluster into abnormal patterns (atypical). Statistics reveal that about 1/10th of one million breast cancer biopsies done in the United States are characterized by atypical hyperplasia. Atypia lesions are not known to be harmful, but they do show some early features of cancer.
When the data from hundreds of women who had these atypical lesions were analysed it was seen that the risk of developing breast cancer in these women increases by one percent every year. After five years, 7 percent of the women developed the cancer, after 10 year the number increased to 13 percent and after about 25 years, 30 percent of the women had developed breast cancer.
As per this study, the women diagnosed with atypical hyperplasia fall into the high-risk category for developing breast cancer and should be intensely screened and must be prescribed medication to reduce risk.
Lynn Hartmann, M.D., an oncologist at Mayo Clinic and lead author of the study said that by providing better risk prediction for this group, the women’s clinical care to their individual level of risk can be tailored.
There have been previous studies which have reported that women with atypia are four to five times more likely to develop breast cancer than women who don’t have these lesions. But, the reason why this study is different is because this study has the patient numbers and follow-up time to report the patients the likelihood that she will develop breast cancer over a certain period of time. To ascertain the risk of developing cancer, the research team at the Mayo clinic followed up with 698 women who had the lesions and who had been diagnosed at the mayo Clinic between 1967 and 2001. A thorough analysis of their pathology and medical records was carried out to determine who developed the cancer and when. The study revealed that the researchers found that after an average follow-up of 12.5 years, 143 women had developed the disease.
The findings of this study were validated by researchers at Vanderbilt University who used biopsies from a separate cohort of women with atypia. Both set of data revealed similar results, about 25 to 30 percent of these women had developed breast cancer.
The results of this study are more relevant as it provides actual data of breast cancer cases that occurred in a population of women with atypia. In this study, the researchers also incorporated information from the patient’s pathology specimen which gave them more accurate results. It was found that as extent of atypia in a biopsy increased, so did the woman’s risk of developing breast cancer.
As per the results of this study, the research team makes the recommendation that since women who have atypical hyperplasia have an increased risk of breast cancer, they should be candidates for screening MRI. The researchers also noted that since many women are not aware of the risk of developing breast cancer, they are not taking anti-estrogen medications like tamoxifen which are known to lower their risk of breast cancer by 50 percent or more. Now that there is evidence of the relation between atypical hyperplasia and breast cancer, these women must be made aware of the risk they are at by their physician.