Ariel Oppong, Jay Lee, Rebecca Gray
Grand Rounds _Hyperplasia powerpoint pdf
Grand Rounds Synopsis- Atypical Hyperplasia of the Breast
Hyperplasia occurs when an organ or tissue becomes enlarged because the cells within it begin to proliferate more quickly than usual, resulting in an abnormally large population of cells in one, concentrated area of the body. We categorize hyperplasia in two ways: (1) “simple” or “complex”, and (2) “usual” or “atypical”. The research we will explore focuses on complex, atypical hyperplasia. This refers to hyperplastic tissue that both engorges the tissue around it and contains deformed, non-uniform cells.
Hyperplasia of the breast falls into two categories: lobular and ductal. Within the fatty tissue of a healthy breast are mammary glands, and within those lie lobular clusters of alveoli. The cuboidal cells that line these alveoli secrete milk, which moves through milk ducts to reach the nipple, where it is excreted during breastfeeding. When hyperplasia occurs in the breast, it is usually found in either the lobules of the mammary gland or the associated milk ducts.
Usually, hyperplasia within the breast is relatively harmless. Because change in breast size and shape occurs normally over the course of a woman’s life, her body is designed to handle minor engorgement of the tissue there. This condition becomes concerning when hyperplastic cells within the breast become atypical; this is characterized by misshapen cytosol, nuclei, and membrane organization. When this occurs, the hyperplastic cells take on characteristics startlingly similar to those of tumors: they are clumped, proliferating rapidly, and lacking functionality. For this reason, atypical hyperplasia of the breast is linked with breast cancer and considered premalignant.
Usually if a lump or an abnormal mass is found during a female’s mammogram then a health professional will usually suggest a biopsy. During the biopsy tissue cells are removed for analysis by a pathologist. If the pathologist can not make a definite decision as to if the excision is cancerous or not.
A 2014 report published by the New England Journal of Medicine published a new meta-analysis of the associated risk of breast cancer associated with atypical hyperplasia. The conclusions of the meta-analysis suggested that a women with a atypical hyperplasia has a least a 30% increased risk of having breast cancer within a 25 year follow-up. Due to this new information we ( the anatomy group) as well as the authors of this newly published report agree that there needs to be a reform in women’s health policies so that women are more aware of their risk and are also more informed about some preventative medicine including screening techniques, and treatment or surgical options if signs of breast cancer are already apparent.
Some of the current commonly used treatments are different types of SERMS. SERMS are selective estrogen receptor modulators. The most widely used antiestrogen for management of breast cancer is Tamoxifen. However, prolonged use of Tamoxifen does increase one’s risk for endometrial (uterine) cancer.
Another important issue is the health disparities in breast cancer diagnosis, quality of treatment, and mortality rates among different socio-economic groups, geographic locations, the unemployed and employed, and racial groups. Based of off data from the 2014 Racial Disparity in Breast Cancer Mortality Study in areas such as Memphis, Tennessee, black women are more than two times more likely to die of breast cancer than their white counterparts. Overall, our research indicates that we as a country need to implement new screening methods, need to promote more education initiatives, need to enact new policies to decrease health disparities, and need to stress the powerful conclusions that meta-analysis provide.