What is the risk of malignancy in fibrocystic pediatric breast disorders?

Updated: Apr 01, 2019
  • Author: Harsh Grewal, MD, FACS, FAAP; Chief Editor: Robert K Minkes, MD, PhD  more...
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Answer

Answer

Patients with proliferative changes, atypia, or both have a higher risk for future malignancies.

Although no specific data are available in adolescents, the risks in adults are well described. Proliferative fibrocystic disease (described histologically as moderate or florid hyperplasia, sclerosing adenosis, or papilloma with a fibrovascular core) has been associated with a 1.5-fold to twofold increased risk of developing breast cancer. The most substantial increase in risk of breast cancer is observed in patients with atypical or lobular hyperplasia; this is associated with a 4.4-fold increase in cancer risk, which increases to ninefold with a positive family history. [22]

Screening guidelines for patients with a history of atypia on breast biopsy findings are still evolving. In adults, current recommendations include yearly physician examinations and yearly mammography. [23] Patients should be aware of the limitations and should be taught how to perform self-examinations on their breasts. No data indicate that the additive radiation from mammography increases the risk of breast cancer. These recommendations should be followed in children and adolescents.


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