The Society of Cancer Management
  • Home
    • An After Life
    • News Archive
  • About
    • Terms & Conditions
    • Privacy Policy
    • Copyright Notice
  • Contact

. . . supporting research that improves cancer survival.

 
Please contact us if you would like to contribute a news item. We are keen to publish more articles from UK-based research and findings that relate to microbial infections during therapy.

Contradiction in the management of breast biopsy abnormalities

3/2/2014

0 Comments

 
Contrary to existing understanding, long-term follow-up of patients with two types of breast tissue abnormalities suggests that both types of abnormalities have the same potential to progress to breast cancer, according to a study published in Cancer Prevention Research, a journal of the American Association for Cancer Research. Findings from this study could improve clinical management of patients with breast tissue abnormalities.

This study challenges current understanding that atypical ductal hyperplasia (ADH), a type of breast tissue abnormality, leads to breast cancer in the same breast while atypical lobular hyperplasia (ALH), another type of breast tissue abnormality, may not be a direct precursor of breast cancer, but may indicate equal risk of breast cancer across both breasts.

"Ours is the first report with sufficient numbers of both types of atypia and long-term follow-up for breast cancers that compared the side of breast that had atypia with the side of breast in which cancer arose and the timeframe when the cancers developed," said Lynn C. Hartmann, M.D., professor of oncology at the Mayo Clinic in Rochester, Minn. "We showed that even though the two types of atypia look different histologically, they behave quite similarly in terms of what happens to patients.

"More than a million American women have a breast biopsy with benign findings every year, and about 10 percent of these biopsies reveal atypical hyperplasia, a premalignant finding with a proliferation of abnormal cells, which have some but not all the features of a breast cancer," she added. "There are two types of atypical hyperplasia based on their microscopic appearance—ADH and ALH—and it has been thought that they behave differently.

"Most have considered ADH a direct precursor to breast cancer, arguing that it requires complete surgical excision while others have maintained that ALH serves as an indicator of heightened and equal risk of breast cancer across both breasts and does not need complete surgical removal," explained Hartmann. "Moreover, some experts have argued that women with atypia develop 'better risk' breast cancers, meaning low-grade cancers with a good prognosis."

Hartmann and colleagues identified 698 women from the Mayo Benign Breast Disease Cohort who had biopsy-confirmed atypia; 330 of them had ADH, 327 had ALH, and 32 had both. The investigators followed these women for an average of 12.5 years, and 143 of them developed breast cancer.

The investigators found that the ratio of breast cancer in the same breast in which the atypia was detected versus in the opposite breast was the same, 2:1, for both ADH and ALH.

A similar number of women with either ADH or ALH developed breast cancer in the same breast within five years of diagnosis, which led the authors to suggest that, like ADH, ALH may also be a precursor in addition to being a risk indicator.

Contrary to current understanding that ALH might mostly lead to the development of lobular cancer, this study found that ALH predominantly resulted in ductal cancer of the breast, which is a similar outcome as with ADH. Both ADH and ALH resulted in invasive ductal cancers, of which 69 percent were of intermediate or high grade. About 25 percent of them had spread to the lymph nodes. The pattern of cancers in these patients resembled those seen in the general population.

"If a woman has a breast biopsy and if it shows atypia, it might be wise for her to be seen at a breast center for recommendations about surveillance and preventive therapy options," said Hartmann. "We hope these data will further help clinicians make informed decisions for breast atypia management strategies."

Hartmann et al., (2014). Understanding the premalignant potential of atypical hyperplasia through its natural history: A longitudinal cohort study. Cancer Prev. Res., EPub Ahead of Print, doi:10.1158/1940-6207.CAPR-13-0222 [Article]
0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Cancer Therapy & Palliative Care News

    This feed features recent developments in cancer therapy and palliative care. Views in these articles do not necessarily represent those of the Cancer Management Society.

    Archives

    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013

    Categories

    All
    General
    Presentation
    Research
    Review

    RSS Feed

Home

About

Contact Us

Terms & Conditions

Privacy Policy

Copyright Notice

RSS Feed

Proudly powered by Weebly
© The Society of Cancer Management 2017