Would surgically removal of breasts eliminate the possibility of breast cancer?

I've just completed a stereotaxic biopsy for both breasts and the diagnosis are as follows:

  Right breast, upper outer quadrant: Atypical ductal   hyperplasia, with microcalfications

  Left breast, upper:  Atypical ductal hyperplasia, with microcalcifications and columnar cell alteration with apical secretions(CAAPS).

The right breast has the similiar findings from both needle and surgical biopsy in April 1998. At the time, there was no mammogram detectable changes in my left breast.

Would you kindly advice me that what the result tells, in terms of my risk for DCIS? And also, if this tells a bigger risk of cancer, is surgical removal of both breasts (I have relatively small size breasts) be a choice of eliminate the possibility of future breast cancer? Thank you for your attention.

[CCF-RN,MSN-JS]

Dear cbgsc, 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.  Preventive mastectomies (surgical removal of both breasts) is a pretty drastic measure, and it's important to realize that this procedure doesn't completely eliminate the risk of breast cancer.  No mastectomy can be guaranteed to get out all of the breast tissue.

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 read is Dr. Susan Love's Breast Book (you can order it through your library or at a bookstore). 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.