Nearly 10% of 444 women who had surgery to reduce the size of their breasts had abnormal-looking cells in the breast tissue that was removed. Doctors call these abnormal-looking breast cells atypical hyperplasia. Atypical hyperplasia is not cancer and not life-threatening, but is associated with a higher-than-average risk of developing breast cancer later in life. The results were presented at the 2009 ASCO Breast Cancer Symposium.
Atypical hyperplasia usually is found during breast biopsy. A biopsy typically is done if a suspicious area is found by mammogram, doctor's physical breast exam, or breast self-exam. If a large number of healthy women had breast biopsies, doctors would expect about 1% of the women to have atypical hyperplasia.
The researchers in this study aren't sure why atypical hyperplasia was found in a higher percentage (nearly 10%) of the women in the study. An earlier study done by the same researchers also found either early cancer that wasn't recognized (occult breast cancer) or atypical hyperplasia in the removed breast tissue of 12% of women who had breast reduction surgery.
In this study, women most likely to have atypical hyperplasia:
- were in their 40s at the time of breast reduction surgery; women in their 40s were about 8 times more likely to have atypical hyperplasia than women younger than 30
- had a family history of breast cancer
- had more than the average number of mammograms or other breast imaging tests before reduction surgery
Because women with atypical hyperplasia have a higher-than-average risk of breast cancer, their doctors will likely talk to them about options to reduce that risk. Premenopausal women may consider taking tamoxifen, a hormonal therapy medicine, to reduce risk. Doctors consider a number of factors, such as age and family history, when deciding whether a treatment to lower breast cancer risk makes sense. In this study, all the women with atypical hyperplasia were referred to a medical oncologist or surgeon to have their risk status evaluated. Based on personal and medical history, hormonal therapy medicine to reduce risk was recommended to about 33% of the women. Only one woman chose to take hormonal therapy.
If you're considering breast reduction surgery, know that your doctor will likely send the removed breast tissue for analysis by a pathologist, even if you have no breast cancer concerns. As this study shows, it's possible that abnormal results, such as atypical hyperplasia, could be found. If you have breast reduction surgery, it's a good idea to ask your doctor to go over the results of the pathology report on the removed breast tissue so you can address any areas concerns together.