••• Chapter 41^ Breast Disorders^411
❍ Based on a pathological classification, how are benign breast disorders divided?
Nonproliferative lesions.
Proliferative lesions without atypia.
Atypical proliferative lesions.
Figure 41.4 A 54-year-old woman with locally advanced infiltrating lobular right breast carcinoma exhibiting inflammatory
and peau d’orange skin changes. Note the foreshortening and retraction of the right breast.
❍ What is the risk of subsequent development of invasive carcinoma in patients with nonproliferative and
proliferative breast disorders?
These lesions carry no increased risk of development of carcinoma as long as the patient does not have a
strong family history of breast cancer. Included in this category are fibroadenomas, duct ectasia, cysts, apocrine
metaplasia, and mild ductal epithelial hyperplasia.
❍ What is the risk of subsequent development of invasive carcinoma in patients with proliferative breast
disorders without atypia?
The risk is 1.5 to 2 times normal.
❍ What is the risk of subsequent development of invasive carcinoma in patients with atypical proliferative
breast disorders?
The risk is increased by about 4 times normal.
❍ What is the relative risk of development of invasive carcinoma of the breast in a patient with ADH?
4 to 5 times.
❍ What is the relative risk of development of invasive carcinoma of the breast in a patient with hyperplasia
(mild)?
1.5 to 2 times.
❍ What is the relative risk of development of invasive carcinoma of the breast in a patient with atypical
lobular hyperplasia (ALH)?
Four to five times.