Classical LCIS

Classical LCIS are non-invasive lesions that remains within the breast lobule and do not grow beyond it. It is not a cancer. “in situ” means that a lesion does not pass the basement membrane which is why this lesion cannot spread to the lymph nodes or other organs. LCIS is thus, non life-threatening. Classical LCIS is merely an indicator of risk and extensive surgery, such as a mastectomy, is not required. It does however, increase your overall risk of developing a cancer in your lifetime twofold when compared to the general population. There is also an increased risk of breast cancer in both breasts, not only within the breast classical LCIS occurred. Surgery is often recommended to remove the lesions.

ADH

Atypical ductal hyperplasia (ADH) is an accumulation of abnormal cells in a breast duct. Women with ADH have a risk of breast cancer that is about four times higher than that of women who don’t have ADH.

Atypical ductal hyperplasia can be a precursor to the development of breast cancer. Over time, if the cells keep dividing and become more abnormal, your condition may be reclassified as a noninvasive breast cancer such as DCIS.

There are no signs or symptoms of ADH and it is usually discovered during a breast biopsy to investigate symptoms caused by another condition or an abnormality found on a mammogram. Surgery is often recommended to remove the lesions.

ALH

Atypical lobular hyperplasia (ALH) is an accumulation of abnormal cells in a breast lobule.

Women with ALH have a risk of breast cancer that is about four times higher than that of women who don’t have atypical hyperplasia.

Atypical lobular hyperplasia can be a precursor to the development of breast cancer. If the ALH cells keep dividing and become more abnormal, your condition may be reclassified as noninvasive breast cancer such as LCIS.

There are no signs or symptoms of atypical lobular hyperplasia and it is usually discovered during a breast biopsy to investigate symptoms caused by another condition or an abnormality found on a mammogram. Surgery is often recommended to remove the lesions.

Radial Scar

Radial scars, also called complex sclerosing lesions, are usually discovered by coincidence when a breast mass or abnormality is removed or biopsied. Occasionally, radial scars are large enough to be detected by mammography. No additional treatment beyond removal is needed for radial scars. The risk of subsequent breast cancer after surgical removal in this population is small and chemoprevention is not usually recommended.

FEA

Flat epithelial atypia (FEA) is a separate entity from ADH or ALH. Typically, FEA is diagnosed coincidentally through breast biopsies done for calcifications found on screening mammograms. The relationship between flat epithelial atypia and cancer is still being defined, but the available data suggests that the risk of local recurrence or progression to invasive cancer is low. Surgery is often recommended to remove the lesions.

Papillomas

Solitary intraductal papillomas can be identified as a mass on a mammogram, ultrasound, MRI, or ductogram. Often there is nipple discharge in these cases.
Solitary papillomas can harbor areas of atypia or ductal carcinoma in situ (DCIS). The diagnosis of malignancy is even higher when the papilloma contains atypical cells. Once the diagnosis of solitary papilloma is confirmed by biopsy, surgery is often recommended to remove the lesions, but no additional treatment is needed. Unless there is associated atypia, there is no increased risk of subsequent breast cancer.