Tamoxifen

[Rfrancis]

I'm 35 at high risk because of the 2 biopsies and one turning out to be ADH (Atypical Ductal Hyperplasia). No History of Breast Cancer in my family. I just met with an oncologist last week, Apparently a very good doctor, his name is Dr. Mark Graham with UNC, and he has suggested for me to take Tamoxifen. I took a bout a week to think about the risks and side effects. I have deceided to take the Tamoxifen, knowing if it does not suit me I can always discontinue the drug. I guess my question is, Does the ADH ever go away? Or will I have this always, and what are the odds of getting it in the other breast? Does the ADH always come in a form of microcalcification or does it reveal it's self in other forms?
Thank you, for your help.Rfrancis

[CCF-RN,MSN-JS]

Dear Rfrancis, Atypical ductal hyperplasia (ADH) describes cells that line the ducts in the breast as being 1) not looking like normal cells (atypical) and 2)there being more than the number of normal cells (hyperplasia).  We are not quite  sure whether ADH increases cancer risk because it is dangerous in itself, or because it's a response to something else that is dangerous that we don't yet know about.  An example would be a bruise that doesn't heal isn't harmful in itself but may be failing to heal because it's over a cancer site.  From studies done following women with ADH the risk of invasive cancer was equal in either breast.  These findings make it more likely that we are picking up women at high risk in this specific group rather than those with a condition that is dangerous in itself.  

For women who want a treatment findings from studies using tamoxifen for prevention have opened up another option. In studies of women using tamoxifen for prevention, the women with ADH who took tamoxifen for five years had an 86 percent decrease in subsequent breast cancers.

Regarding your question about how ADH is detected - ADH rarely "cause" lumps, pain or other symptoms and is often found incidentally. As in your situation: a biopsy of the suspicious area of microcalcifications.

[Binkie]

http://www.cancervic.org.au/cancer1/prevent/breasthealth/adh.htm