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Atypia with columnar cell and ductal hyperplasia
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Atypia with columnar cell and ductal hyperplasia

After a sterotactic core needle biopsy, the path report read, "fibrocystic changes with adenosis and apocrine metaplasia. Foci of microcalcification are present within the adenosis foci. There is columnar cell alteration and focal flat epithelial atypia." The presence of atypia prompted a wire-guided excisional biopsy.

After the excisional biopsy, the path report read, "Areas of ductal hyperplasia including areas of columnar cell hyperplasia. I have not identified a significant degree of atypia. Areas of apocrine hyperplasia and apocrine cyst formation are also noted. An area compatible with prior needle biopsy site is identified wih reactive granulation tissue. No evidence of carcinoma."

Good news, and apparently most of the atypia was removed with the needle biopsy. My surgeon has recommended a normal 12-month follow-up mammogram and nothing more.

My question is, with atypia and columnar cell hyperplasia and ductal hyperplasia, is it usual to wait 12 months for follow-up, or should I go back at 6 months? Also, how much does this finding increase my risk for future breast cancer? Thank you in advance for your input!
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Dear braveheart2:  Ductal hyperplasia without atypia and columnar cell hyperplasia may increase relative risk of developing breast cancer very slightly in the absence of any other risk factors.  Atypical ductal hyperplasia (which is not mentioned in this report) is more commonly associated with a slightly increased risk of breast cancer in the absence of additional risk factors.  In either case, the recommendation for follow –up is vigilant monthly self-breast examination and annual clinical breast examination and mammogram.  Your personal follow up recommendations should be based on your risk outside of this biopsy.  You should discuss this with your doctor who can put this in the context of your situation.
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