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atipical lobular hyperplasia
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atipical lobular hyperplasia

Hi everyone. I am 39yrs and have a family hx of breast cancer. Mother, maternal aunt and great maternal aunt. I have been annual mammograms since I was 36 due to family history. My last mammo was abnormal and I had a diagnostic ultrasound which indicated the need for a biopsy. The biopsy came back atipical lobular hyperplasia. Then my surgeon suggested a mri. That showed some abnormality so I had another breast u/s of both breast. Now the radiologist is suggesting 3 more biopsies I am wondering if this is common or could  the alh is just the beginning of something more serious. Any comments would be greatly appreciated. :)
Hi there,
You have a family history of breast cancer.  Your doctors are being very careful and doing all the tests.  Atipical lobular hyperplasia means you need to pay attention to your breast health. It does not mean you have cancer.
My niece had the same thing about your age.  We have have a family history
of breast cancer.  My niece is now 45 and sees the doctor every 6 months for a check up.  She is fine.  It's very important that you give the same kind of attention your doctors are to keep your breasts healthy.   I'm a breast cancer survivor who has a Hugh family history of breast cancer.  Sounds like you have some good doctors.  Go for all your scheduled appointments.
Hello there and welcome to the forum though I wish this was under better circumstances for you.

I have been off the boards myself for a few days as I have just had my 5th chemotherapy treatment for breast cancer and mention it here only so  that you know that I understand firsthand the fears and anxieties that immediately present themselves for anything related to breast cancer and to let you know that you are not alone and that I care

The fact that you have a family history obviously slants the dice a little so let's see if we can start at the beginning and reach a place of more knowledge and understanding so that you can begin to start making choices that are suitable for you and what you would like to see for yourself and your family

This sort of situation provides so many different options that getting that knowledge is a very powerful tool in your arsenal. Forgive me if you already know much of this but I don't want to make assumptions and have you miss something that may be useful for you later.

So what is Atypical Lobular Hyperplasia:

Atypical lobular hyperplasia (ALH) is "not" breast cancer, but is considered a precancerous condition. Atypical lobular hyperplasia occurs when the epithelial cells lining your milk lobes, produce far more cells than would normally grow there. Some of these cells are irregular in shape and size, thus they are called “atypical”. Usually, a lobe is lined with one even layer of uniformly shaped cells, but in lobular hyperplasia there are often be several layers of these cells.

So what does this mean for you and the future?

Well, this places you in an uncomfortable position unfortunately - because you are neither here, nor there and that can be one of the most anxious places to be. But the news is excellent here so by focusing on that, I believe we can get you to a happier place and in one where you feel you have more control over this that likely what you are feeling right now.

Take a deep breath with me and here we go

The main problem with a diagnosis of atypical lobular hyperplasia means that your lifetime risk for developing breast cancer is 4 to 5 times the average risk. Atypical lobular cells are abnormal and have the potential for developing into lobular carcinoma in Situ (LCIS), a type of noninvasive breast cancer.

You will need to be vigilant about your breast health, and may possibly have a breast MRI along with your annual screening mammogram. Women between the ages of 45 to 55 with atypical hyperplasia have the highest future risk of developing breast cancer and It is difficult to predict which cases of atypical lobular hyperplasia will remain benign and which may become malignant,

Many patients just need extra screening mammograms to keep track of any changes. Some patients may choose a type of surgery to remove the suspicious tissue. If you have a family history of breast or ovarian cancer, or if you have a BRCA genetic mutation, you'll need to balance that in with your treatment decisions.

So where to from here..

This is where it gets tricky as many specialists have differing opinions as to how to approach this diagnosis and it is here that I hope you will forgive me when I say take your time, learn what you need to learn and only when YOU feel happy and comfortable about the path you have decided upon with your medical team, should you proceed.

Treatment Options for Atypical Lobular Hyperplasia:

Some doctors advise their patients to be extra mindful of their breast health with atypical lobular hyperplasia.  Most cases may never develop into breast cancer. But considering your family history, it is likely you might consider surgery and medications to lower your risk.

Some of the options available are:

Lumpectomy - surgery to remove the tissue and a small margin of surrounding tissue
Tamoxifen - a daily pill that selectively blocks the estrogen receptor, for women with a family history of breast cancer
Raloxifene - also a daily pill that selectively blocks the estrogen receptor
Avoid HRT - hormone replacement therapy uses estrogen and progestin, two hormones which reduce menopause symptoms, but which also fuel most breast tumors

This is an awful lot of information to pass off at you in one go, but there positive news here is that you are already having the correct tests done, in a timely fashion and at a place where you do not have cancer - just th warning bells that give you and your team plenty of time to set up a robust plan, whether it be monitoring only, or a more aggressive approach as you most definitely have the gift of choice.

Please stay in touch, my apologies again if I gave out too much info - but I hope you glean the real good news here is that there is time to plan, discuss.. or simply chose to watch and do nothing but monitor.

All my very best wishes to you

The key to surviving breast cancer is catching it as fast as you can.  That's is
why, if you have a family history of breast cancer - stay on top of it.  I have a Hugh family history of breast cancer.  Both grandmothers, my mother and all her sisters.  They also suspect my great-grandmother had it also.  
My cancer was caught at stage 1 because I didn't take chances..  Your doctors are getting all the information they can to get baseline information for the future to compare and also to not over look anything because of your history.  FYI:  I'm a 13 year breast cancer survivor.  
Thank you for making quite clear the main factor that influences treatment options so greatly for breast cancer - which is catching it in the early stages and I'm glad you've posted your story as a wonderful example on monitoring and then immediate action.
However, I have met many who find waiting just far to stressful to cope with year after year and opt for a surgical approach immediately.

None of these choices is right or wrong but need to feel comfortable to the person having to make that choice.

Congrats on your 13 years
Thank you so very much do  the info,and congratulations to you. Well after the mri last week I has another breast ultrasound the next day per the request of  the radiologist. Unfortunately there were 3 more suspicious masses that we r confirmed from the mri. .I'm scheduled for 3 more biopsies on Wed. 2 more on the  left breast and one on the right. I was scheduled for a lumpectomy for 4-16 but it was cancelled. So right now I am faced with a very scary diagnosis. The waiting it the absolute worst.. I am trying to stay positive  but I also am aware of the reality of all of this. I just pray that if it is confirmed that it has been caught early. Thank you so much for your response. It really does make a difference when there is someone to talk to who has been there. Thank you again. :)
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