Table of ContentsView AllTable of ContentsSymptomsCausesBreast Cancer RiskDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Breast Cancer Risk
Diagnosis
Treatment
Atypical lobular hyperplasia(ALH) is the abnormal growth of cells in the milk-producing glands of the breast (known as lobules). ALH specifically affects epithelial cells lining the walls of lobules.
ALH is aprecancerouscondition that could lead to the earliest stage ofbreast cancer, known asductal carcinoma in situ (DCIS). Because the risk of cancer is increased if you have ALH, you would need to undergo routine breast cancer screening. Others at high risk of breast cancer may be advised to undergo surgery.
This article explains the symptoms and causes of atypical lobular hyperplasia, including how it is diagnosed and treated. It also describes the odds of getting breast cancer if diagnosed with ALH.
gorodenkoff / Getty Images
Also Known AsLobular hyperplasia with atypiaMammary atypical lobular hyperplasiaEpithelial atypical hyperplasiaProliferative breast disease
Also Known As
Lobular hyperplasia with atypiaMammary atypical lobular hyperplasiaEpithelial atypical hyperplasiaProliferative breast disease
Symptoms of Atypical Lobular Hyperplasia
Atypical lobular hyperplasia doesn’t usually cause any symptoms, although it can cause non-specificbreast painin some people. Most people are unaware they have ALH until they get the results of a routine mammogram.
This is because ALH doesn’t usually cause a lump. If it does, it is usually very small and unlikely to be noticed during abreast self-exam.
Signs and Symptoms of Breast Cancer
Causes and Risk Factors of ALH
The exact cause of atypical lobular hyperplasia is unknown. Scientists believe it is the result of lifetime exposure to the female sex hormoneestrogen. It usually affects females in their 40s and can also affect men, albeit very rarely.
Risk factors of ALH include:
ALH is similar toatypical ductal hyperplasia (ADH)which also causes the proliferation of abnormal cells in the ducts leading from the lobules.
How Serious Is ALH and the Risk of Breast Cancer?
Atypical lobular hyperplasia is a high-risk, precancerous lesion that can evolve into ductal carcinoma in situ (DCIS).
DCIS is a condition that affects the epithelial cells that line the walls of a breast lobule. Carcinomas are cancers that specifically affect epithelial cells.
Over time, DCIS can turn intoinvasive ductal carcinoma (IDC), the most common type of breast cancer. Depending on the grade of the tumor, it can take anywhere from three to nine years for DCIS to evolve into IDC.
Research suggests that the risk of developing breast cancer is as high as 20% if you have been diagnosed with ALH.That is significantly higher than the overall risk of breast cancer among females in the United States, which runs around 13%.
How Atypical Lobular Hyperplasia Is Diagnosed
Imaging and a tissue biopsy are needed to confirm an atypical lobular hyperplasia diagnosis.
ALH is found in 5% to 20% of breast biopsies.
Breast Biopsy: What to Expect
How Is Atypical Lobular Hyperplasia Treated?
Many cases of ALH do not require treatment and will instead be monitored regularly to check for any changes in breast tissues. This is called active surveillance.
Some people may be advised to undergo surgery, either in the form of a wide local excision (used to remove all the affected tissues along with a small margin of unaffected tissues) or alumpectomy(if an actual lump is present).
Candidates for surgery include those at high risk of breast cancer who:
It is difficult to predict which cases of ALH will remain benign and which may turn cancerous, so surveillance is essential. This may include extra screeningmammogramsand/orbreast magnetic resonance imaging (MRI)to identify any changes as early as possible.
Breast cancer fisk-reduction strategies are also advised, including:
You should also ask your healthcare provider ifhormonal birth controlor estrogen replacement therapy is right for you given that they can increase the risk of certain cancers.
Summary
ALH is a type of precancer in which abnormal cells develop in the milk-producing glands of the breast. ALH can lead to an early-stage cancer called ductal carcinoma in situ (DCIS) in up to one of every five people with ALH.
ALH often does not require treatment but will instead be regularly monitored with a screening mammogram and/or a breast MRI. Some people at high risk of breast cancer may have the ALH lesions removed just to be safe.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Breastcancer.org.Lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia.Myers DJ, Walls AL.Atypical breast hyperplasia. In:StatPearls. StatPearls Publishing; 2021.Danforth DN.Molecular profile of atypical hyperplasia of the breast.Breast Cancer Res Treat. 2018 Jan;167(1):9-29. doi:10.1007/s10549-017-4488-xAmerican Cancer Society.Key statistics for breast cancer.American Cancer Society.Tamoxifen and raloxifene for lowering breast cancer risk.Additional ReadingCoopey SB, Mazzola E, Buckley JM, et al.The role of chemoprevention in modifying the risk of breast cancer in women with atypical breast lesions.Breast Cancer Res Treat.2012;136(3):627-633. doi:10.1007/s10549-012-2318-8Degnim AC, Dupont WD, Radisky DC, et al.Extent of atypical hyperplasia stratifies breast cancer risk in 2 independent cohorts of women.Cancer. 2016. 122(19), 2971–2978. doi:10.1002/cncr.30153. doi:10.1002/cncr.30153
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Breastcancer.org.Lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia.Myers DJ, Walls AL.Atypical breast hyperplasia. In:StatPearls. StatPearls Publishing; 2021.Danforth DN.Molecular profile of atypical hyperplasia of the breast.Breast Cancer Res Treat. 2018 Jan;167(1):9-29. doi:10.1007/s10549-017-4488-xAmerican Cancer Society.Key statistics for breast cancer.American Cancer Society.Tamoxifen and raloxifene for lowering breast cancer risk.Additional ReadingCoopey SB, Mazzola E, Buckley JM, et al.The role of chemoprevention in modifying the risk of breast cancer in women with atypical breast lesions.Breast Cancer Res Treat.2012;136(3):627-633. doi:10.1007/s10549-012-2318-8Degnim AC, Dupont WD, Radisky DC, et al.Extent of atypical hyperplasia stratifies breast cancer risk in 2 independent cohorts of women.Cancer. 2016. 122(19), 2971–2978. doi:10.1002/cncr.30153. doi:10.1002/cncr.30153
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Breastcancer.org.Lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia.Myers DJ, Walls AL.Atypical breast hyperplasia. In:StatPearls. StatPearls Publishing; 2021.Danforth DN.Molecular profile of atypical hyperplasia of the breast.Breast Cancer Res Treat. 2018 Jan;167(1):9-29. doi:10.1007/s10549-017-4488-xAmerican Cancer Society.Key statistics for breast cancer.American Cancer Society.Tamoxifen and raloxifene for lowering breast cancer risk.
Breastcancer.org.Lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia.
Myers DJ, Walls AL.Atypical breast hyperplasia. In:StatPearls. StatPearls Publishing; 2021.
Danforth DN.Molecular profile of atypical hyperplasia of the breast.Breast Cancer Res Treat. 2018 Jan;167(1):9-29. doi:10.1007/s10549-017-4488-x
American Cancer Society.Key statistics for breast cancer.
American Cancer Society.Tamoxifen and raloxifene for lowering breast cancer risk.
Coopey SB, Mazzola E, Buckley JM, et al.The role of chemoprevention in modifying the risk of breast cancer in women with atypical breast lesions.Breast Cancer Res Treat.2012;136(3):627-633. doi:10.1007/s10549-012-2318-8Degnim AC, Dupont WD, Radisky DC, et al.Extent of atypical hyperplasia stratifies breast cancer risk in 2 independent cohorts of women.Cancer. 2016. 122(19), 2971–2978. doi:10.1002/cncr.30153. doi:10.1002/cncr.30153
Coopey SB, Mazzola E, Buckley JM, et al.The role of chemoprevention in modifying the risk of breast cancer in women with atypical breast lesions.Breast Cancer Res Treat.2012;136(3):627-633. doi:10.1007/s10549-012-2318-8
Degnim AC, Dupont WD, Radisky DC, et al.Extent of atypical hyperplasia stratifies breast cancer risk in 2 independent cohorts of women.Cancer. 2016. 122(19), 2971–2978. doi:10.1002/cncr.30153. doi:10.1002/cncr.30153
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
