ALH /ADH same breast

[monkey2late]

I had a excisonal biopsy 3/05 Path report was ALH/ ADH
same breast well develpoed ALH with ductal involvement by cells
of ALH : Focal ADH : Papillary Apocrine change, Sclerosing Adenois.  I also have first degree family history (sister dx IDC
at age 46). I am 48 .
Do the presence of both ALH/ADH with Papillary Apocrine
and Sclerosing Adenosis  increase my risks further or are these changes that are normaly found with ADH and ALH ? I have not found any information on having both ALH/ADH in the same breast?
Thank you in advance for any information you can give me.

[CCF-RN,MSN-rf]

Dear Monkey2late:  The presence of atypical ductal hyperplasia (ADH) is associated with an increased risk of breast cancer. Atypical lobular hyperplasia (ALH) is less of concern than ADH. It is a possible precursor to lobular carcinoma in situ. Unlike ductal carcinoma in situ, which is considered and treated as cancer, LCIS is considered more of a precursor to or risk factor for cancer than actual cancer. So it's really 2 levels removed from cancer, and is not an absolute precusor at that. meaning, it's not at all clear that ALH would necessarily lead to LCIS, nor would LCIS necessarily lead to invasive lobular cancer. So, in fact, with ALH most people would recommend regular followup, but nothing more. Bottom line: While the ALH may not significantly increase your risk of developing breast cancer, the ADH and the sister with breast cancer are both risk factors that would increase your risk.  In terms of follow up, you may benefit from a discussion with a breast specialist or genetic counselor who can discuss with you the best options for surveillance and/or prevention.

[monkey2late]

Thank you so much for your response !