Usual Ductal Hyperplasia of Breast

Usual Ductal Hyperplasia of Breast

Article
Women's Health
Diseases & Conditions
+1
Contributed byKrish Tangella MD, MBAFeb 09, 2022

What are the other Names for this Condition? (Also known as/Synonyms)

  • Benign Epithelial Hyperplasia of Breast
  • Ductal Hyperplasia without Atypia and Epitheliosis
  • Intraductal Hyperplasia of Breast

What is Usual Ductal Hyperplasia of Breast? (Definition/Background Information)

  • Usual Ductal Hyperplasia of Breast is a benign proliferation of breast duct cells. It is a fairly common condition generally seen in middle-aged and older women
  • There are no specific predisposing factors known for Usual Ductal Hyperplasia of Breast. The cause of this abnormality may be due to genetic factors
  • There are no significant signs and symptoms of Usual Ductal Hyperplasia of Breast noted. However, there is a slight increase in overall risk for breast cancer in individuals with the condition (1.5-2 times increased risk over the general population)
  • Usual Ductal Hyperplasia of Breast is diagnosed on a breast biopsy by a pathologist when examined under the microscope. Since the condition is benign and no presentations are noted, no treatment is generally required

Who gets Usual Ductal Hyperplasia of Breast? (Age and Sex Distribution)

  • Usual Ductal Hyperplasia of Breast is a common condition observed in middle-aged and older women; rarely, men are also affected
  • The average age of diagnosis of the condition is 54 years
  • The condition can affect individuals of all races and ethnic backgrounds

What are the Risk Factors for Usual Ductal Hyperplasia of Breast? (Predisposing Factors)

  • No specific risk factors have been identified for Usual Ductal Hyperplasia of Breast

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Usual Ductal Hyperplasia of Breast? (Etiology)

The exact cause of development of Usual Ductal Hyperplasia of Breast is presently not well-understood.

  • Researchers believe that the condition is caused by proliferation of progenitor cells within the breast
  • Certain genetic abnormalities have been reported in the formation of the condition. Research is believed that activating mutations in the gene pathway called PI3K/AKT/mTOR pathway may be contributive

What are the Signs and Symptoms of Usual Ductal Hyperplasia of Breast?

Most cases of Usual Ductal Hyperplasia of Breast may not exhibit any signs and symptoms.

  • One or both breasts may be affected
  • The condition is generally painless
  • A presence of lump or mass is not observed in the breast

How is Usual Ductal Hyperplasia of Breast Diagnosed?

Usual Ductal Hyperplasia of Breast may be diagnosed in the following manner:

  • Complete physical examination with comprehensive medical and family history evaluation. On clinical examination (physical examination of breast), the condition does not cause a mass or lump within the breast
  • Breast exam to check for any lumps or unusual signs in the breasts
  • Mammogram: A mammogram uses X-rays to provide images of the breast. The condition does not usually cause any radiological abnormalities on a mammogram
  • Breast ultrasound scan: Using high-frequency sound waves to produce images of the breast
  • Computerized tomography (CT) or magnetic resonance imaging (MRI) scan of the breast: On radiological studies occasionally, the condition may be associated with microcalcifications. On magnetic resonance imaging of the breast the condition may show radiological enhancement
  • Breast biopsy:
    • A biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
    • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
    • Sometimes, the pathologist may perform additional studies, which may include immunohistochemical stains and molecular studies to assist in the diagnosis

Biopsies are the only methods used to determine whether an abnormality is benign or cancerous. These are performed by inserting a needle into a breast mass and removing cells or tissues, for further examination. There are different types of biopsies:

  • Fine needle aspiration biopsy (FNAB) of breast mass: In this method, a very thin needle is used to remove a small amount of tissue
  • Core needle biopsy of breast mass: A wider needle is used to withdraw a small cylinder of tissue from an abnormal area of the breast
  • Open tissue biopsy of breast mass: A surgical procedure used less often than needle biopsies, it is used to remove a part or all of a breast lump for analysis

It is estimated that in over 20% of the benign breast biopsies, there is a component of usual ductal hyperplasia.

The differential diagnosis to exclude conditions with similar presentations include:

  • Atypical ductal hyperplasia of breast
  • Intermediate grade ductal carcinoma in situ of breast
  • Low-grade ductal carcinoma in situ of breast
  • Micropapillary ductal carcinoma in situ of breast
  • Solid papillary carcinoma of breast

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Usual Ductal Hyperplasia of Breast?

There may not be any significant complications of Usual Ductal Hyperplasia of Breast.

  • The condition is associated with an increased risk for subsequent breast cancer. It is estimated that the overall increase is 1.5-2 times over the general population
  • The risk may be even higher for individuals who have a positive family history of breast cancer

How is Usual Ductal Hyperplasia of Breast Treated?

  • No treatment is necessary for Usual Ductal Hyperplasia of Breast since it is a benign condition
  • Follow-up care with regular breast self-examinations and screening mammograms may be recommended by the healthcare provider

How can Usual Ductal Hyperplasia of Breast be Prevented?

Currently, no specific preventive measures are available to prevent Usual Ductal Hyperplasia of Breast. In general, it is important to be aware of the following:

  1. Regularly conduct breast self-exams to ensure that no lumps are present
  2. Maintain a healthy body weight and exercise regularly
  3. Implement and follow a well-balanced diet; a high intake of fiber via fresh fruits and vegetables helps in a healthy lifestyle
  4. Avoid or completely stop smoking
  5. If taking alcohol, only drink in moderation; limit to one or (maximum) two drinks a day
  6. Limit combination hormone therapy used to treat symptoms of menopause. It is advised that individuals be aware of the potential benefits and risks of such hormonal medications

What is the Prognosis of Usual Ductal Hyperplasia of Breast? (Outcomes/Resolutions)

The prognosis of Usual Ductal Hyperplasia of Breast is generally excellent since it is a benign condition.

Additional and Relevant Useful Information for Usual Ductal Hyperplasia of Breast:

The following DoveMed website links are useful resources for additional information:

https://www.dovemed.com/healthy-living/womens-health/

https://www.dovemed.com/diseases-conditions/cancer/

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Krish Tangella MD, MBA picture
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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