by Jason Wasserman MD PhD FRCPC and Zuzanna Gorski MD
July 14, 2024
Background;
Usual ductal hyperplasia (UDH) is a benign (non-cancerous) condition that occurs in the ducts of the breast. It involves an increase in the number of cells lining the ducts.
What are the symptoms of usual ductal hyperplasia?
Most patients with UDH do not have any symptoms, and UDH alone cannot be seen when a breast imaging test such as mammography is performed. UDH cannot be felt as a lump in the breast unless it is associated with a tumour.
What causes usual ductal hyperplasia?
The exact cause of UDH is not fully understood, but several factors are thought to contribute to its development:
Hormonal influence
- Estrogen: Estrogen plays a significant role in breast tissue development and is believed to contribute to the proliferation of ductal cells. High estrogen levels, whether from endogenous sources (the body’s own production) or exogenous sources (hormone replacement therapy or oral contraceptives), can stimulate the growth of ductal cells.
- Progesterone: This hormone also influences breast tissue, but its exact role in usual ductal hyperplasia is less clear than estrogen.
Genetic factors
- Genetic Predisposition: Some individuals may have a genetic predisposition to develop UDH. While specific genetic mutations have not been definitively linked to UDH, a family history of breast cancer or benign breast conditions can indicate a higher likelihood of developing UDH.
Age and reproductive history
- Age: UDH is more common in women of reproductive age, particularly those in their 40s and 50s.
- Reproductive History: Women who have had multiple pregnancies or who began menstruating at an early age may have an increased risk due to prolonged exposure to estrogen.
Environmental and lifestyle factors
- Diet and Obesity: High-fat diets and obesity can increase estrogen levels, potentially leading to the development of UDH.
- Alcohol Consumption: Regular alcohol intake has been linked to higher estrogen levels and may contribute to the development of UDH.
Is usual ductal hyperplasia associated with an increased risk of developing breast cancer?
UDH is associated with a small increased risk of developing breast cancer in the future. Current studies suggest that a person diagnosed with UDH is 1.5 to 2 times more likely to develop breast cancer in their lifetime compared to someone who is not diagnosed with UDH. However, the overall risk of developing breast cancer with UDH alone is very low.
How is the diagnosis of usual ductal hyperplasia made?
The diagnosis of UDH can be made after a small sample of tissue is removed from the breast in a procedure called a biopsy. UDH may also be seen in a larger piece of tissue removed to treat another condition.
What does usual ductal hyperplasia look like under the microscope?
When examined under the microscope, your pathologist will see more epithelial cells that fill and expand some of the ducts. Other noncancerous changes, such as cysts, calcifications, and apocrine metaplasia, may also be seen in the tissue sample.
About this article
Doctors wrote this article to help you read and understand your pathology report. Contact us with any questions about this article or your pathology report. Read this article for a more general introduction to the parts of a typical pathology report.
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