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Breast Cancer  (Expert Forum)
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Understanding risks
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

Understanding risks

by Vballerite, Apr 16, 2002 12:00AM
My surgical biopsy indicated that I  had fibrocystic change (fibrosis, microsyst formation, apocrine metaplasia and papillomatosis with associated calciumm oxalate crystals)
ductal hyperplasia without atypia
No evidence of carcinoma.
My surgeon told me that none of the above were directly associated with an increase risk in breast cancer, but added that because there were various changes in my breast, that alone could be an indicator that my breasts were more prone to change, and would consequently be at more risk. In researching the terms, it appears to me that the increased risk is about 2 x what it would be if I did not have the changes. Is this correct?
Also, since I have evidence of hyperplasia, what is the likelihood of the hyperplasia developing into atypical hyperplasia, a much higher risk factor than non-atyipcal?
I have a family history of metastatic breast cancer (my mother).  Would my sisters be more likely to have the same risks?

Thanks very much.

by CCF-RN,MSN-JS, Apr 16, 2002 12:00AM
Dear vballerite, We do not know what actually may be causing changes such as hyperplasia (too many cells in the duct), or if the 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.  

Other data looking at family history and risk of breast cancer a woman's relative risk with a mother having breast cancer is about 2.3.  If she was pre-menopausal when diagnosed with cancer the relative risk would be 2.7.

Your sisters would have the same risk based on family history.  Whether or not they have or will develop hyperplasia is impossible to predict.
Member Comments (1)

by redhead1951, Mar 08, 2009 07:46PM
A related discussion, beast biopsy was started.
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