Noncancerous Breast Lumps That Increase Cancer Risk

We previously explained that not every breast lump is cancer. Here we discuss noncancerous changes that increase cancer risk (LCIS) or may turn into cancer (DCIS).

Atypical hyperplasia 

• Atypical lobular hyperplasia (ALH) develops with abnormal cells in the breast’s milk lobules.
• Atypical ductal hyperplasia (ADH) develops with abnormal cells in milk ducts.

Lobular carcinoma in situ (LCIS)

LCIS involves abnormal cells in breast lobules, more than in ALH. Because these cells do not spread outside the lobules, it is called in situ (only in its original location).

When these findings occur, the abnormal cells are not cancer cells. If ALH, ADH or LCIS is present, consult a breast health specialist. Recommendations based on personal and family medical history may include:

• Annual mammography
• Physical breast examination every 6 months or annually
• Tamoxifen (for all women) or raloxifene (for all postmenopausal women). These drugs reduce breast cancer risk in some women.
• Surgery. A small number of women with LCIS and high breast cancer risk may choose surgery.

Ductal carcinoma in situ (DCIS)

It is characterized by abnormal cells in the milk duct wall. Unlike spreading cancer cells, that is invasive breast carcinoma, these cells do not spread outside the duct and are therefore called in situ (only in its original location).

Not every DCIS becomes invasive breast cancer. Treatment is needed because which cases will become cancerous is unknown. Treatment depends on how much breast tissue is affected, its location and grade. Most women with DCIS are cured with appropriate treatment.

DCIS treatment options:

• Lumpectomy. This is breast-conserving surgery, usually followed by radiotherapy.
• Mastectomy. It removes part or all of the breast. Methods differ according to tissue and lymph node amounts removed.
• Tamoxifen. It may reduce DCIS recurrence or prevent invasive breast cancer.