Hyperplasia of the Breast

Breast hyperplasia is a term used to describe the abnormal growth of cells in the breast tissue. It is not a specific diagnosis but rather a general term encompassing a range of conditions involving increased cell proliferation within the breast ducts or lobules. Breast hyperplasia can be broadly categorized into ductal hyperplasia and lobular hyperplasia.

Ductal Hyperplasia

This type of hyperplasia involves the overgrowth of cells in the milk ducts of the breast. It can be further classified into two subtypes:

• Usual ductal hyperplasia

In this case, the cells in the ducts proliferate abnormally but do not exhibit atypical or precancerous changes. The cells look very close to normal.

• Atypical ductal hyperplasia (ADH)

This subtype involves the proliferation of atypical or abnormal cells within the ducts. While not cancerous, it is considered a high-risk lesion, as it may increase the risk of developing breast cancer in the future.

Lobular Hyperplasia

This type of hyperplasia specifically involves the overgrowth of cells in the lobules of the breast.

• Usual lobular hyperplasia

In this subtype, the cells within the lobules are proliferating excessively but do not look very abnormal.

• Atypical lobular hyperplasia (ALH)

ALH refers to the proliferation of atypical or abnormal cells within the lobules. ALH is associated with a higher risk of developing breast cancer compared to usual lobular hyperplasia.

Breast hyperplasia is typically identified through breast biopsy or imaging studies, such as mammograms or breast ultrasounds, which may show areas of increased cell density or suspicious changes in breast tissue. The significance of hyperplasia in terms of breast cancer risk varies depending on several factors, including the subtype of hyperplasia (with or without atypia), family history, and other risk factors. Breast hyperplasia can also be identified from a needle biopsy.

While usual hyperplasia is generally not associated with a significantly increased risk of breast cancer, atypical hyperplasia may indicate a higher risk. Individuals with atypical hyperplasia may be closely monitored. They may require additional breast cancer risk assessment and management strategies, including increased surveillance, preventive measures, or discussions about potential preventive medications.

Usual breast hyperplasia is considered a normal finding and typically does not need to be treated. If atypical breast hyperplasia is found from a needle biopsy, surgery may sometimes be recommended to remove breast tissue in that area to make sure no cancer cells are also in that area. Otherwise, most atypical breast hyperplasia cases do not require treatment as it is challenging to predict which cases will become malignant and which will stay benign. As such, surveillance is crucial for those with atypical breast hyperplasia. This may include more frequent breast screenings to identify worrying changes as early as possible.

It is important for individuals diagnosed with breast hyperplasia to have a comprehensive discussion with their healthcare provider to fully understand their specific condition, its implications, and any recommended follow-up or risk-reduction strategies. Breast health and cancer risk assessment should consider the individual's medical history, family history, and other risk factors to develop a personalized care plan. By being informed about their condition and the available options, individuals can take an active role in managing their health. This will allow them to make informed decisions and take the necessary steps to reduce their risk of breast cancer.