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Treatments and drugs
By Mayo Clinic staffAtypical hyperplasia is generally treated with surgery to remove the abnormal cells and to make sure no in situ or invasive cancer also is present in the area. Doctors often recommend more frequent screening for breast cancer and strategies to reduce your breast cancer risk.
Follow-up tests to monitor for breast cancer
Your doctor may recommend you undergo follow-up tests to screen for breast cancer. This may increase the chance that breast cancer is detected early, when a cure is more likely. Talk about your breast cancer screening options with your doctor. Your options may include:
- Self-exams of your breasts to develop breast familiarity and to detect any unusual breast changes
- Clinical breast exams by your health care provider once or twice a year
- Screening mammograms every year
- Screening breast magnetic resonance imaging (MRI), depending on other risk factors, such as a strong family history or a genetic predisposition to breast cancer
Ways to reduce your risk of breast cancer
To reduce your risk of developing breast cancer, your doctor may recommend that you:
- Take preventive medications. Treatment with a selective estrogen receptor modulator (SERM), such as tamoxifen or raloxifene (Evista), for five years may reduce the risk of breast cancer. These drugs work by blocking estrogen from binding to estrogen receptors in breast tissue. Estrogen is thought to fuel the growth of some breast cancers. Another option for certain women may be exemestane (Aromasin), which decreases production of estrogen in the body.
- Avoid menopausal hormone therapy. Researchers have concluded that combination hormone therapy to treat symptoms of menopause — estrogen plus progestin — increases breast cancer risk in postmenopausal women. Many breast cancers depend on hormones for growth.
- Participate in a clinical trial. Clinical trials test new treatments not yet available to the public at large that may prove helpful in reducing breast cancer risk associated with atypical hyperplasia. Ask your doctor if you're a candidate for any clinical trials.
- Consider risk-reducing (prophylactic) mastectomy. For women at very high risk of breast cancer, risk-reducing mastectomy — surgery to remove one or both breasts — reduces the risk of developing breast cancer in the future. You might be considered at very high risk of breast cancer if you have a genetic mutation in one of the breast cancer genes or you have a very strong family history of breast cancer that suggests a likelihood of having such a genetic mutation.
But this surgery isn't right for everyone. Discuss with your doctor the risks, benefits and limitations of this risk-reducing surgery in light of your personal circumstances. If you have a strong family history of breast cancer, you might benefit from also meeting with a genetic counselor to evaluate your risk of carrying a genetic mutation and the role of genetic testing in your situation.
- Lester SC. The breast. In: Kumar V, et al. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-1-4377-0792-2..X5001-9&isbn=978-1-4377-0792-2&uniqId=273803839-4. Accessed Aug. 17, 2011.
- Bombonati A, et al. The molecular pathology of breast cancer progression. Journal of Pathology. 2011;223:307.
- Hartmann LC, et al. Benign breast disease and the risk of breast cancer. The New England Journal of Medicine. 2005;353:229.
- London SJ, et al. A prospective study of benign breast disease and the risk of breast cancer. Journal of the American Medical Association. 1992;267:941.
- Degnim AC, et al. Stratification of breast cancer risk in women with atypia: A Mayo cohort study. Journal of Clinical Oncology. 2007;25:2671.
- Dupont WD, et al. Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer. 1993;71:1258.
- Breast cancer risk reduction. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Aug. 17, 2011.
- Breast cancer screening and diagnosis. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Aug. 17, 2011.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 31, 2011.
- Goss PE, et al. Exemestane for breast-cancer prevention in postmenopausal women. The New England Journal of Medicine. 2011;25:2381.
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