Bilateral Major Breast Duct Excision

I got my pathology report back from dr.  It states that I had multiple cysts in both breasts containing blue-green fluid.  And dilated duct-like structures within the fibrous tissue.  The final report states.  Right breast- fibrocystic change.  Left breast-fibrocystic change with focal florid ductal hyperplasia and duct ectasia.  My Dr. stated that the condition I have is caused by my estrogen levels being so high.  And that he is concerned and wants to repeat mammogram in 6 months and keep an eye on this.  My questions are what does this report mean?  And if it is not cancerous, why is he so worried about it?  Does this mean that my chances are higher of getting cancer in the future, just don't have it right now?  I have breast cancer in my family on my mothers side.  And would I be a candidate for tamoxifen?  Or am I worrying and thinking too much?  All the info you can give me will be greatly appreciated.  Thankyou!

[CCF-RN,MSN-JS]

Dear karen61268, We do not know what actually may be causing changes such as hyperplasia (too many cells in the duct), or if the fact having hyperplasia will progress to something atypical. In Dr. Susan Love's Breast Book she describes a study done by a David Page, of Vanderbilt University. He studied 10,000 biopsies and found, not surprisingly, that there was a progression of risk going from hyperplasia to atypical hyperplasia etc. The women with hyperplasia and no atypia had a slightly increased relative risk (barely significant), which was worse when compounded with family history. (Relative risk means: if you call the risk of a woman without any particular risk factors 1.0, you can then report risk of those with a particular risk factor in relation to this) So if a normal woman has a relative risk of 1.0 over a lifetime. A woman with hyperplasia would be 1.5, compounding that with family history her relative risk would be about 2.1. These were the findings in this particular study.

The best person to make recommendations for your individual situation might be either a medical breast specialist or a genetic counselor who can look at all of your risk factors and determine the best plan of surveillance for you, and whether taking a chemoprevention approach would be recommended.