Breast Lesion: Atypical Ductal Hyperplasia

Hyperplasia is a term used to denote a sudden growth of body cells in a particular part of the body. Breast atypical ductal hyperplasia is associated with the cells that line the milk ducts, which are located in the glandular tissue of the breast. These cells support the milk ducts. These milk ducts carry milk from lobules to the nipple. Atypical ductal hyperplasia is a condition, in which the cells lining the milk ducts of the breast grow abnormally.

Normally these milk ducts are lined with even number of layers. When these cells multiply, and grow in number, shape and size, many layers of cells are produced. This results in the changed appearance of breasts. The atypical ductal hyperplasia can develop in one breast but in some cases, it develops in both the breasts. This condition is rarely observed in men. This growth, though non-cancerous, increases the risk of breast carcinoma or breast cancer in women.

Symptoms and diagnosis of atypical ductal hyperplasia
Usually, there are no symptoms that indicate atypical ductal hyperplasia of breasts. In rare cases, symptoms such as formation of lumps, thickening of the area, changes in the nipple or breast pain are observed. Therefore, in case of positive breast cancer signs, or an abnormal mammogram, doctors recommend a breast biopsy.

Treatment of atypical ductal hyperplasia
After the diagnosis of typical ductal hyperplasia, the patient is usually asked to undergo a surgery to remove the abnormal growth. Generally, it is removed by wide local excision surgery or lumpectomy. This is followed by frequent breast exams and screening mammograms to check the occurrence of breast cancer. Magnetic resonance imaging (MRI) of breasts is also done for patients who have a genetic history of cancer. Patients with genetic predisposition to breast cancer are given 5 years medication of selective estrogen receptor modulator (SERM) like tamoxifen (Nolvadex) and raloxifene (Evista). These medications hinder the action of estrogen in the breast tissue. For patients with greater risk of developing breast cancer, preventive mastectomy (that is, surgical removal of breasts) is recommended. This minimizes the chances of developing breast cancer in the future.

Precautions to avoid breast cancer
Women who have or who have had atypical ductal hyperplasia need to be more careful about the changes in shape and size of the breasts. Whenever there is any unusual change in the breast area, skin and nipple or if there is a lump near the breast or under the arm and nipple discharge, consult an oncologist immediately. Since these are some of the early symptoms of breast cancer. Patients should do self examination of the breast, at least once a month, followed by physical check up by the doctor twice a year and yearly mammogram. They should not take any hormonal therapy, for example estrogen, progestin, without consulting the doctor. Some factors like tobacco, alcohol consumption, stress and lack of exercise trigger the risks of breast cancer.

Any unusual change in the breasts should not be neglected. Early detection of the breast atypical ductal hyperplasia, regular follow-up and an appropriate treatment minimizes the risks of developing breast cancer.