atypical ductal hyperplasia

Although different sources will give you different risks, please know that all of our current models, except perhaps if you also have a BRCA mutation, are pretty poor at predicting YOUR risk of breast cancer.

The most used breast cancer risk model is the Gail model.  http://www.cancer.gov/bcrisktool/

Different studies will give you different numbers.

Know that when they say 'you have risk 5 times higher',this does NOT mean 5x the risk of an AVERAGE woman (i.e. is NOT NOT NOT 5x13%=65%; 13% is the lifetime risk of breast cancer for the 'average' US woman), but 5 times the risk of a woman WITHOUT any particular breast cancer risk factors (besides being a woman).  There are different figures for this,but they usually range a lifetime risk of about 3-5%.  So 3x5=15% lifetime risk, and 5x5=25% max.

This study found ALH gave more of a risk than ADH in premenopausal women. http://www.ncbi.nlm.nih.gov/pubmed/17154175

In this small study that included ADH women, their risk of breast cancer over 5 years was about 5%. These results support current literature showing the synergistic increase in risk for patients with ADH, LCIS, and a positive family history of breast cancer. Obesity was also a strong predictor of breast cancer risk, which suggests that there may be a potentiating effect of obesity on other risk factors. Obesity may represent a modifiable risk factor, providing women with an opportunity to reduce their risk with lifestyle modification. Women with a strong family history of breast cancer or a diagnosis of ADH or LCIS may benefit most from risk-reduction strategies, chemoprevention, and surveillance.http://www.ncbi.nlm.nih.gov/sites/entrez

Our population included 1,412 high-risk women with median follow-up of 4 years. Of 195 women < or =35 years, 3 (1.5%) developed breast cancer. All three had strong FHBC and none had a prior high-risk lesion. Of 82 women > or =70 years, 6 (7.3%) developed breast cancer. Mean Gail score for women > or =70 years was 4.3, as compared with 4.7 in the subset of older women diagnosed with cancer. Fisher's tests demonstrated that ADH (p = 0.15), ALH (p = 1.0), LCIS (p = 1.0), and FHBC (p = 1.0) were not associated with breast cancer development in older women. We conclude that, for women < or =35 years, a significant FHBC may be a stronger predictor for breast cancer development than high-risk lesions. For women > or =70 years, FHBC and history of ADH, ALH, and LCIS were not predictors of breast cancer. This study emphasizes the importance of defining age-appropriate recommendations for breast cancer risk management, including surveillance and chemoprevention.http://www.ncbi.nlm.nih.gov/pubmed/18979140

The Gail model is quite good at predicting the breast cancer risk for USA  populations (for example, how many women in a group of women will get breast cancer), but it is quite poor at predicting which PARTICULAR women will get breast cancer.

In this 2006 medical journal article, they compared the Gail model  to an Italian model (which included other factors like breast density).  They took one randomly selected woman who had been diagnosed with breast cancer and compared her initial model score with a  randomly selected woman who had NOT been diagnosed with breast cancer.  If a model was 100% accurate, her concordance value would be 1:in each pair, each woman with breast cancer would get a higher score than each woman without breast cancer.  If the model was as good as chance, the concordance value would be 0.5, meaning in 50% of the pairs, the woman with breast cancer would get a higher score than the woman without breast cancer,but in 50% of the pairs, the woman WITHOUT breast cancer would get a higher score.  In other words, if you have a model with a concordance value of 0.5, the model isn't a good predictive model.

Decarli et al. also assessed each model’s performance at the level of the individual woman. A model that discriminates well at this level should consistently predict a higher risk of breast can- cer for women who will be diagnosed with the disease than for women who will not. Decarli et al. randomly selected pairs of women, one of whom was diagnosed with breast cancer and one of whom was not, to determine the frequency with which each model calculated a higher risk for the woman who developed breast cancer. The resulting calculation produced a concordance statistic, whose value could range from 0.50 (equivalent to a coin toss) to 1.0 (perfect discrimination). The concordance statistics for the Italian and Gail models were essentially the same, ap- proximately 0.59 (with 95% confidence intervals that ranged from 0.54 to 0.63). In other words, for 59% of the randomly se- lected pairs of women, the risk estimated for the woman who was diagnosed with breast cancer was higher than the risk estimated for the woman who was not. Unfortunately, for 41% of the pairs of women, the woman with breast cancer received a lower risk estimate than her cancer-free counterpart. Thus, for any given woman, the two models were better at prediction than a coin toss—but not by much. http://jnci.oxfordjournals.org/cgi/reprint/98/23/1673.pdf  (emphasis mine).

If it is this difficult to predict breast cancer risk for an 'average' woman, think how much we know about women with increased risk. This can make it difficult to decide what to do based on numbers.

The server went down, so I can't search for more.

There is no rush what to do.  Visit both your brain and your heart, (and your insurance) to see what path you want to take.

leaf has given you a lot of information about your risk level to get breast cancer, now that you've been diagnosed with ADH.  As she said, your risk is probably in the range of about 15% - 25%.

My question for you is whether the doctor you've been dealing with is a breast specialist, a general surgeon or your family doctor or gyn.  If you have not been seeing a breast specialist, then I would strongly recommend that you see one.  With ADH, you are right at the edge of the 'high risk' category for getting breast cancer.  Because of this, a breast specialist might recommend something more than just annual mammograms.  Perhaps he/she will recommend alternating ultrasounds and mammos, every 6 months.  Or if you have very dense breast tissue, he/she might recommend an annual MRI.  It reallly depends on where you fall within the ADH risk levels - whether you are at the high end or the low end of the risk scale.  A breast specialist is the best doctor to assess this, based on other factors in your health and family history.  And that will determine the best screening program for you.