Common Breast Biopsy Finding May Be More Dangerous Than Thought

Thirty percent of women with 'atypical hyperplasia' eventually developed breast cancer, study found

By Kathleen Doheny

HealthDay Reporter

WEDNESDAY, Dec. 31, 2014 (HealthDay News) -- Women who have a pre-cancerous condition known as atypical hyperplasia of the breast are at higher risk of developing breast cancer than experts had believed, a new study finds.

Hyperplasia is an overgrowth of cells. When it occurs in a distorted pattern, it's called atypical hyperplasia. This condition is found in about one-tenth of the more than one million breast biopsies with benign findings done in the United States each year, according to researchers from the Mayo Clinic.

In the new study, the researchers found that about 30 percent of the women with atypical hyperplasia developed breast cancer in the 25 years after the diagnosis.

While experts have always known that atypical hyperplasia increases the risk of breast cancer, the new finding gives women with the condition more solid information about the extent of the risk, said study researcher Dr. Lynn Hartmann, a professor of oncology at the Mayo Clinic in Rochester, Minn.

Before the study, experts believed that women with atypical hyperplasia had about a four times higher risk of breast cancer, she said. That doesn't tell women their specific individual risk, however, Hartmann noted.

In the study, Hartmann's team followed nearly 700 women diagnosed with atypical hyperplasia at the Mayo Clinic between 1967 and 2001. After an average follow-up of more than 12 years, 143 women had developed breast cancer.

Hartmann's team validated the findings with a separate group of women with the condition at Vanderbilt University. Both sets of data found that around 30 percent of the women with atypical hyperplasia developed breast cancer.

As the extent of the hyperplasia increased, so did the risk, the investigators found.

The new research gives women some valuable information, according to two experts who reviewed the findings. One strength of the study was the "sizable sample of women followed for a long time," said Robert Smith, director of cancer screening for the American Cancer Society.

"We've always known their risk was higher," Smith said of women with the condition. However, the new study provides long-term data, he said, and shows a risk higher than most experts believed it to be.

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Herceptin May Benefit Some Women With Early Breast Cancer

Drug-chemo combo yields low rate of recurrence after three years, study says

By Amy Norton

HealthDay Reporter

WEDNESDAY, Jan. 7, 2015 (HealthDay News) -- For some women with early breast tumors, lower-dose chemotherapy and the drug Herceptin may help ward off a cancer recurrence, a new study suggests.

Experts said the findings, published in the Jan. 8 New England Journal of Medicine, could offer the first standard treatment approach for women in the early stages of HER2-positive breast cancer.

HER2 is a protein that helps breast cancer cells grow and spread, and about 15 to 20 percent of breast cancers are HER2-positive, according to the U.S. National Cancer Institute.

Herceptin (trastuzumab) -- one of the newer, so-called "targeted" cancer drugs -- inhibits HER2. But while Herceptin is a standard treatment for later-stage cancer, it wasn't clear whether it helps women with small, stage 1 breast tumors that have not spread to the lymph nodes.

Women with those cancers have a relatively low risk of recurrence after surgery and radiation -- but it's high enough that doctors often offer chemotherapy and Herceptin as an "adjuvant," or additional, therapy, explained Dr. Sara Tolaney, of the Dana-Farber Cancer Institute in Boston.

The challenge, Tolaney said, is balancing the potential benefits against the side effects. So for the new study, her team tested a low-intensity chemo regimen -- 12 weeks of a single drug, called paclitaxel -- plus Herceptin for one year.

The researchers found that women who received the drugs were highly unlikely to see their breast cancer come back over the next three years. Of the 406 study patients, less than 2 percent had a recurrence.

There was no control group that did not receive chemo and Herceptin for comparison. But the results are "better than expected," said Dr. Charles Shapiro, co-director of the Dubin Breast Center at Mount Sinai Hospital in New York City.

Shapiro, who was not involved in the study, said it's still not clear what the benefits could be in the longer term.

"Three years of follow-up is short," he said. "Time will tell if there are late recurrences."

In other studies of women with small breast tumors (up to 1 inch across), recurrence rates over five years have ranged widely -- from 5 to 30 percent, Tolaney said.

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