Hyperplasia of the Breast (Ductal or Lobular)

Hyperplasia is also known as epithelial hyperplasia or proliferative breast disease. It’s an overgrowth of the cells that line the ducts or the milk glands (lobules) inside the breast.

Hyperplasia may be called either ductal hyperplasia (also called duct epithelial hyperplasia) or lobular hyperplasia based on how the cells look under a microscope. Ductal and lobular hyperplasia occur at about the same rate, and have about the same effect on breast cancer risk.

Hyperplasia is often described as usual or atypical based on how the cells look.

  • In usual hyperplasia, the cells look very close to normal.
  • In atypical hyperplasia (or hyperplasia with atypia), the cells are more distorted. This can be either atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH).

Diagnosis

Hyperplasia doesn’t usually cause a lump that can be felt, but it can cause changes that can be seen on a mammogram. It’s diagnosed by doing a biopsy. (A hollow needle may be used to remove a small piece of tissue that’s checked in the lab. Or, surgery may be done to take out the abnormal breast tissue.)

How does hyperplasia affect your risk for breast cancer?

Hyperplasia can affect your risk for breast cancer, but how much depends on what type it is:

  • Mild hyperplasia of the usual type: This does not increase the risk for breast cancer.
  • Moderate or florid hyperplasia of the usual type (without atypia), also known as usual hyperplasia: The risk of breast cancer is about 1½ to 2 times that of a woman with no breast abnormalities.
  • Atypical hyperplasia (either ADH or ALH): The risk of breast cancer is about 4 to 5 times higher than that of a woman with no breast abnormalities. More details about pathology reports showing atypical hyperplasia can be found in Understanding Your Pathology Report: Atypical Hyperplasia.

Treatment

Most types of usual hyperplasia do not need to be treated. But if atypical hyperplasia (ADH or ALH) is found on a needle biopsy, more breast tissue around it might be removed with surgery to be sure that there is nothing more serious nearby, such as cancer.

Reducing breast cancer risk or finding it early

Atypical hyperplasia (ADH or ALH) is linked to a higher risk of breast cancer. Even though most women with atypical hyperplasia will not develop breast cancer, it's still important to talk with a health care provider about your risk and what, if any, options are best for you.

Options for women at high risk of breast cancer from atypical hyperplasia may include:

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Collins LC, Schnitt SJ. Chapter 9: Pathology of benign breast disorders. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2014.

Guray M, Sahin AA. Benign breast diseases: Classification, diagnosis, and management. Oncologist. 2006;11:435-449.

Hartmann LC, Degnim AC, Santen RJ, Dupont WD, Ghosh K. Atypical hyperplasia of the breast — Risk assessment and management options. N Engl J Med. 2015;372:78-89.

Hartmann LC, Sellers TA, Frost MH, et al. Benign breast disease and the risk of breast cancer. N Engl J Med. 2005;353:229-237.

McEvoy MP, Coopey SB, Mazzola E, et al. Breast cancer risk and follow-up recommendations for young women diagnosed with atypical hyperplasia and lobular carcinoma in situ (LCIS). Ann Surg Oncol. 2015;22:3346-3349.

National Cancer Institute. Understanding Breast Changes: A Health Guide for Women. 2015. Accessed at www.cancer.gov/types/breast/understanding-breast-changes on August 15, 2017.

National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Breast Cancer Risk reduction. Version 1.2017. Accessed at www.nccn.org/professionals/physician_gls/pdf/breast_risk.pdf on September 18, 2017.

Orr B, Kelley JL. Benign breast diseases: Evaluation and management. Clin Obstet Gynecol. 2016;59(4):710-726.

Sabel MS. Overview of benign breast disease. UpToDate. 2017. Accessed at www.uptodate.com/contents/ overview-of-benign-breast-disease on August 15, 2017.

 

Last Medical Review: September 20, 2017 Last Revised: September 20, 2017

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