High Risk Treatment

In your opinion what would be the best options of treatment for Atypical ductal hyperplasia. Family Hx... No breast cancer in family, I'm 35 never had childredn, no plans for childeren. I'm going to see an oncologist in a few weeks, and would like to have an idea of options so I can be some what educated when I see the oncologist. Any information would be helpful.

[CCF-RN,MSN-JS]

Dear Rfrancis, Atypical hyperplasia is often referred to as a pre-cancer, however, whether it will go on to develop into an invasive cancer is not known.  Questions remain as to what the best course to follow in terms of what to do about this condition.  At this time most surgeons would agree that the best program is close follow-up, to find a cancer in its early stages.  This would include physical exam by a doctor every six months and yearly mammograms.  Another option might be monitoring using a procedure called ductal lavage.  Treatment options might be looked at in terms of chemoprevention with a medication like tamoxifen, the risks and benefits of such an approach would need to be thoroughly discussed.  

All of these approaches would need to be discussed in terms of your individual risk, risk of the procedure and the benefit expected in your individual case.  A resource you may want to look at prior to your discussion with the oncologist is Dr. Susan Love's Breast Book.  There is a chapter in the book entitled precancerous conditions and she does a good job of describing atypical hyperplasia, along with risk and what's done about it.