What is breast hyperplasia?

Breast hyperplasia is a very common gynecological disease. Breast hyperplasia can cause problems in women's breasts, some of which can make it difficult for women to become pregnant or even make them infertile. Breast hyperplasia needs timely treatment, otherwise it will cause lesions if it is not treated as soon as possible. Breast hyperplasia can cause a large number of lesions in breast cells and tissues, and even have the risk of cancer. So, what is breast hyperplasia?

In pathology, proliferative lesions of the breast are collectively referred to as ductal proliferative lesions, which are a group of proliferative lesions with different cell morphology and tissue structure, mainly confined to the mammary lobular system. These lesions can be roughly divided into 3 categories:

1. Proliferative lesions: breast cysts, duct ectasia, apocrine metaplasia or tissue hyperplasia. In general, the risk of breast cancer in women with proliferative breast lesions is not significantly increased compared with women of the same age who have not undergone surgical biopsy.

2. Common ductal hyperplasia This is a benign proliferative lesion in which the proliferating cells are arranged like an assembly line. The risk of cancer in patients with common ductal hyperplasia increases by 1.2 to 2.0 times, which is a mild increase in risk.

3. Atypical ductal epithelial hyperplasia [Naisi2] is a neoplastic intraductal lesion characterized by monocellular proliferation and uniform distribution of cells. Patients with atypical ductal hyperplasia have a 4- to 5-fold increased risk of cancer, which is a moderate increase in risk and is a precancerous lesion. Based on the morphological characteristics under the microscope, atypical hyperplasia can be further divided into mild, moderate and severe atypical hyperplasia.

Although breast hyperplasia is neither a tumor nor an inflammation, it still needs to be taken seriously. Clinically, it has been confirmed that a small number of cases of severe atypical hyperplasia diagnosed by biopsy can progress to invasive breast cancer, with an average time of 8.3 years. Unfortunately, there is currently no clear indicator of carcinogenesis that can identify which patients with atypical hyperplasia will eventually develop breast cancer.

Ordinary breast hyperplasia itself does not require treatment, only atypical hyperplasia lesions require surgical removal. If atypical hyperplasia is found by core needle puncture, minimally invasive surgery or excisional biopsy before surgery, especially moderate to severe atypical hyperplasia, the suspicious lesion needs to be completely removed to obtain sufficient specimens for pathological diagnosis. Patients should be followed up closely after surgery. High-risk women with a family history of breast cancer or other malignant tumors should consult a specialist to see if they need to take endocrine drugs for treatment and, if necessary, undergo genetic testing (such as BRCA1/2) to further determine breast cancer prevention strategies.