Fax: (615) 343-7023
Excellent survival, cancer type, and Nottingham grade after atypical lobular hyperplasia on initial breast biopsy†
Article first published online: 7 AUG 2006
Copyright © 2006 American Cancer Society
Volume 107, Issue 6, pages 1227–1233, 15 September 2006
How to Cite
McLaren, B. K., Schuyler, P. A., Sanders, M. E., Jensen, R. A., Simpson, J. F., Dupont, W. D. and Page, D. L. (2006), Excellent survival, cancer type, and Nottingham grade after atypical lobular hyperplasia on initial breast biopsy. Cancer, 107: 1227–1233. doi: 10.1002/cncr.22113
Presented in part at the 94th Annual Meeting of the United States and Canadian Academy of Pathology, February 26 to March 4, 2005. Abstract published in Modern Pathology, 2005;18(Supp 1):42A.
- Issue published online: 1 SEP 2006
- Article first published online: 7 AUG 2006
- Manuscript Accepted: 6 JUN 2006
- Manuscript Revised: 25 MAY 2006
- Manuscript Received: 7 MAR 2006
- National Cancer Institute
- National Institutes of Health
- Department of Health and Human Services. Grant Numbers: RO1 CA-50468, RO1 CA-62212, RO1 CA-31698, P50 CA098131
- breast neoplasms;
- atypical lobular hyperplasia;
- time-based cancer risk
Atypical lobular hyperplasia (ALH) is associated with a 10% to 20% risk of subsequent invasive carcinoma, primarily in the ipsilateral breast. Nottingham grading, special tumor types, and survival after invasive cancer diagnosis were analyzed consistently for the first time.
A longitudinal follow-up study of 252 women who underwent 261 benign surgical biopsies between 1950 and 1985 with a diagnosis of ALH was undertaken. Subsequent invasive breast cancers were graded and subtyped based on histologic features and the cohort assessed for cancer survival.
Forty-eight (19%) women developed invasive breast cancer at an average of 15.1 years. Twenty (42%) of the tumors were special subtype tumors with good prognosis. By an average of 13 years after invasive cancer diagnosis, 2 (10%) of 20 women with special type and variant tumors had died of breast cancer, compared with 9 (32%) of 28 women with tumors of no special type (24 tumors) or an unknown type (4 tumors). Only 1 patient with a tumor of low Nottingham grade died of breast cancer.
ALH is a nonobligate cancer precursor associated with a moderate risk of breast cancer and predicts that later cancers are associated with overall excellent survival. Nearly half of the subsequent cancers show classic or variant patterns of special types with a good prognosis and the majority are of low or intermediate combined histologic grade. Treatment of women with ALH should be influenced by their modest elevation in breast cancer risk and the good prognosis and low mortality of many of these cancers. Cancer 2006. © 2006 American Cancer Society.