Rates of atypical ductal hyperplasia have decreased over
the past decade — a finding that may be attributed to the decreasing rate
of postmenopausal hormone therapy use.
Researchers have confirmed that postmenopausal HT use is
associated with atypical ductal hyperplasia, a known risk factor for breast
cancer. Using data on screening mammograms done between 1996 and 2005 from
mammogram registries in the Breast Cancer Surveillance Consortium, the
researchers found more than 2.4 million screening mammograms. These mammograms
were associated with 1,064 biopsies with atypical ductal hyperplasia, 853
breast cancers with atypical ductal hyperplasia and 8,161 cancers with no
atypical ductal hyperplasia.
During the study period, the rate of postmenopausal HT
use decreased from 35% to 11%. At the same time, atypical ductal hyperplasia
rates decreased from 5.5 per 10,000 mammograms in 1999 to 2.4 per 10,000
mammograms in 2005. In addition, rates of cancer with atypical ductal
hyperplasia reduced from 4.3 per 10,000 mammograms in 2003 to 3.3 per 10,000 in
2005.
Atypical ductal hyperplasia was most common in women
with a family history of breast cancer (OR=1.25; 95% CI, 1.04-1.50),
perimenopausal women (OR=1.75; 95% CI, 1.07-2.73) and current postmenopausal HT
users (OR=1.54; 95% CI, 1.29-1.83). Cases of cancer with atypical ductal
hyperplasia were highest among women aged 70 to 79 years (OR=1.84; 95% CI,
1.87-2.31), women with a family breast cancer history (OR=1.63; 95% CI,
1.36-1.95) and those women currently using HT (OR=1.38; 95% CI, 1.14-1.67).
Cancers associated with atypical ductal hyperplasia were
more likely to be ductal carcinoma in situ and were more likely to be grade 1
or 2 compared with cancer without atypical ductal hyperplasia.
Menes TS. Cancer Epidemiol Biomarkers Prev.
2009;18:2822-2828.
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