Benign Proliferative Breast Disease

The two most common types are:

 Atypical hyperplasia (an abnormal increase in the ductal (atypical ductal

hyperplasia) or lobular (atypical lobular hyperplasia) cells in the breast and is
usually found incidentally in mammography

 Lobular carcinoma in situ (is characterized by a proliferation of cells within the

breast lobules.
o LCIS is usually found incidentally on pathologic diagnosis because it cannot be seen on
mammography and does not form a palpable lump.
o The term LCIS is misleading because it is not a carcinoma.
o These diagnoses increase a woman’s risk of breast cancer.

Cancer of the Breast

Breast cancer is the most common invasive cancer in women.
Risk Factors for Breast Cancer

 Female gender
 Increasing age
 Personal history of breast cancer
 Family history of breast cancer
 Hormonal factors
o Early menarche
o Late menopause
o Nulliparity
o First child after 30 years of age
o Hormone therapy (HT)

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 Exposure to ionizing radiation during adolescence and early adulthood
 History of benign proliferative breast disease
 Obesity
 High-fat diet (controversial)
 Alcohol intake
 Genetic mutations.

Pathophysiology and Etiology

 Most breast cancer begins in the lining of the milk ducts, sometimes in the
lobule.
 Eventually it grows through the wall of the duct and into the fatty tissue.
 Family history accounts for approximately 7% of all breast cancers.
 Present knowledge does not indicate that carcinogens play an important role in
the development of breast cancer.
 Several models exist that attempt to predict the short-term or lifetime risk of
breast cancer for women with identifiable factors associated with the disease.

Types of Breast Cancer

Ductal Carcinoma in Situ

 DCIS is characterized by the proliferation of malignant cells inside the milk
ducts without invasion into the surrounding tissue.
 DCIS is frequently manifested on a mammogram and considered breast cancer
stage 0.
 If untreated, there is a risk of invasive cancer.
 The most traditional treatment is total or simple mastectomy, with a cure rate of
98% to 99%

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 The addition of tamoxifen (Nolvadex) significantly reduced local recurrence
rates after surgery and radiation.
 The medication is usually prescribed for 5 years.