Atypical hyperplasia of the breast is a benign but high risk condition that can be either ductal (ADH) or lobular (ALH); these occur with equal frequency and together are found in about 10% of breast biopsies. Either entity confers a long term risk of breast cancer that approaches 30% at 25 years of follow-up.
Atypical hyperplasia of the breast reflects proliferation of dysplastic epithelial cell populations. It is felt to be a transitional zone between benign and malignant breast disease, containing some but not all features of a cancer. Although statistically the long term risk of breast cancer equals or exceeds that conferred by family history and other risk factors, current guidelines in screening do not reflect this. Similarly, pharmacologic risk reduction strategies have been adopted by <1% of women who could potentially benefit from them.
Atypical Hyperplasia of the Breast—Risk Assessment and Management Options
National Comprehensive Cancer Network. Breast cancer screening and diagnosis.
ACOG Practice Bulletin 164: Diagnosis and Management of Benign Breast Disorders
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