Atypical Hyperplasia

CMBCrafts

I am curious does Atypical Hyperplasia reoccur and is it possible for it to reoccur in the same area as the excisional biopsy I already had?

I know I am probably just being nutty, but I had an excisional biopsy and they removed the entire area. I was suggest to take Tamoxifen, but after doing some research chose against it.

I do not know my family history as I was adopted, I went for re-checks every 6 months a couple of times and then they dropped it back to once a year.

 I was just curious as in the area where I had the excisional biopsy I am feeling a lump, but it seems like I can move it around so I don't know if it is something to worry about or if it is just scar tissue from them doing the biopsy before.

 I know I am probably being overcaustious or making something of nothing, just worries me.

 Does atypical hyperplasia reoccur?

Beesie

Just as conditions such as DCIS and IDC can recur, ADH and ALH can also recur (I'm not sure which you had).  Still, you have to keep in mind that atypical hyperplasia itself is not a problem - it can remain in the breast - the reason it's removed is because it may be hiding a more serious condition (ADH and DCIS often are found together).  ADH and ALH are also indictors that you are higher risk to get breast cancer in the future (approx. 4X risk or about 20%, vs. 12.5% risk for the average woman). 

ADH doesn't usually form as a lump - was yours a lump originally?  In all likelihood, what you are feeling is scar tissue, or it could even be something completely different, like a cyst.  However even if you are almost certain that it's nothing serious, it's always a good idea to get any lump or any change in your breast checked out.  So I'd suggest that you go to your doctor, get it checked and hopefully confirmed that it is just scar tissue or something harmless.  Then you'll be able to relax and not worry!

Anonymous

I'm not sure if "reoccur" is the correct term, but I do know that a person who has had atypical hyperplasia removed can indeed have atypical hyperplasia again, either near the original site or anywhere else in the same breast or the other breast.  Also, having had atypical hyperplasia puts you at an increased risk of developing breast cancer.

There will be some scar tissue at the site of an excisional biopsy, but there is no way for you to know for certain if that is what you are feeling.  You should have it checked.  Even if it's not time for your yearly mammogram/ultrasound, go see your doctor.  You are not being nutty, or overcautious - you are being very smart.  Hopefully it is nothing, and you can rest easy and have peace of mind.

Please keep us posted.

Dukemom

leaf

I agree with Dukemom.  I don't know if we actually know the 'natural history' of atypical hyperplasia. You certainly can have atypical hyperplasia in one spot, which may be removed, and then later they can find more in another place. 

 Can atypical hyperplasia recurr? They usually don't use the term 'recurrance' with atypical hyperplasia. I am guessing if you are asking if you have removed the area that contains the atypia, is it possible to have more atypia grow in the same area.   Part of the problem is answering your question is that it is very difficult to do studies to actually answer your question.  The ducts in your breast are a convoluted set of tubes that do not interconnect.  They look kind of like a sagebrush.  If they take out a section of tissue and have clear margins, they may or may not have removed that entire duct or lobule.  You can have ADH or DCIS in several different sections of one duct, separated by more normal looking sections of the duct. So it can be hard to tell if you have 'removed it all'.   It is certainly not necessary to remove all ALH or ADH or LCIS.  One reason is because we can't tell where else it is in the breast except by biopsing all over.  At least LCIS (which I have) puts both breasts at risk, even if it is found in one spot in one breast. Its weird.

As far as I know, we don't know what the ADH or ALH or LCIS does, or what environment has triggered the abnormal cells that puts both breasts at higher risk, even in the places that don't contain abnormal looking cells.

 The vast majority of women with ADH or ALH and nothing worse will never get breast cancer. But they are at higher risk than the average woman, so they need to be followed closely.

 As Bessie says, the reason they excise is to make sure there isn't anything worse going on in the area. 

 Atypical hyperplasia usually is not felt, and usually is an incidental finding on biopsy.  

After my excision, I had a hard spot on my breast for several months, which gradually resolved.

Do report any changes to your breast to your breast surgeon.  As Dukemom says, you will be smart for doing so.  The docs did NOT shame me for reporting my symptoms. I ended up getting a biopsy of the site a year later, which showed scar tissue.