Breast cancer is the leading cancer disease that causes death in women in the age range 25 to 49 years old. It has also been observed that younger patients have lower survival rate and higher chances of cancer recurring back compared to older women. Thus, it is important to understand how the cancer develops and the ways to prevent it.
Breast cancer may be malignant or benign. Although benign breast cancer may not seem to be clinically important, it can actually present significant risks not previously known.
There are 3 types of benign breast disease, namely:
- the non-proliferative disease
- the proliferative disease without atypia
- the atypical hyperplasia
Atypical hyperplasia is characterized by a high number of abnormal-looking cells lining the milk duct. These cells, however, are not cancerous. In proliferative disease without atypia, a large number of cells line the milk duct but they look normal. Non-proliferative disease, on the other hand, is characterized by fibrocystic changes but has no increase in cell numbers.
A recent study at the well-known Mayo Clinic investigated which of the benign disease can become cancerous. The study was based on 4,460 women with benign breast cancer with an average age of 39 years old. Among the group, 2% have been diagnosed with atypical hyperplasia, 72% had non-proliferative disease while 26% have proliferative disease without atypia. The scientists tracked the progress of these women for several years and found out that, within the group, 326 eventually developed breast cancer several years later.
The result showed that atypical hyperplasia can increase a young woman’s chance of getting breast cancer even if there was no history of breast cancer in her family. In fact, women with atypical hyperplasia are three times more likely to develop breast cancer compared to those diagnosed with the other two benign types. However, history of breast cancer in the family may slightly increase the risk of breast cancer in those women diagnosed with these two benign forms. Another interesting finding was that the risk for cancer is reduced in women with benign cancer if the “milk-producing lobular duct glands” where the cancer usually develops shut down. This process is known as lobular regression or involution.
“The impact of lobular involution on risk, even in young women with benign breast disease, is an interesting finding,” Dr. Ghosh, lead investigator says. “It suggests that future research could potentially think about ways of promoting lobular involution as a means to reduce breast cancer risk.”
The take home message is: a diagnosis of benign breast cancer shouldn’t just be taken for granted!