Breast Cancer Research and Treatment

, Volume 118, Issue 1, pp 1–7 | Cite as

Risk factors for breast cancer from benign breast disease in a diverse population

  • Maria J. Worsham
  • Usha Raju
  • Mei Lu
  • Alissa Kapke
  • Alyssa Botttrell
  • Jingfang Cheng
  • Varsha Shah
  • Adnan Savera
  • Sandra R. Wolman
Preclinical Study

Abstract

Background The majority of studies have reported risks of breast cancer (BC) from benign breast disease (BBD) in essentially homogenous Caucasian populations. Information on breast cancer risk factors in larger, multi-ethnic populations should facilitate the development of appropriate and targeted risk reduction strategies. Design Cases and controls were drawn from a parent BBD cohort of 4,970 women, 1,341 African–Americans (AA) and 3,629 non-AA who were diagnosed with BBD after examination of an excisional breast biopsy. Risk factors (34 variables) included demographics, lesion types, and epidemiological variables. Results The final multivariable model retained significance (P < 0.05) for lesion risk-level, fibroadenoma, and the interaction of age-by-race. Women with proliferative lesions (no atypia, risk level 2) were 1.7 times more likely to develop BC when compared with women with non-proliferative lesions (OR = 1.7, 95% CI 1.13, 2.42, P = 0.009). Women with atypia (risk level 3) were 3.75 times more likely to develop BC compared to women with non-proliferative lesions (OR = 3.75, 95% CI 1.99, 7.06, P < 0.001). The odds of breast cancer was approximately 35% lower among women with fibroadenoma as compared to women without fibroadenoma (OR = 0.65, 95% CI 0.46, 0.94, P = 0.020). AA women with BBD who were 50 years or older were 2.28 times more likely to develop breast cancer as compared to non-AA women who were less than 50 years old (OR = 2.28, 95% CI 1.34, 3.88, P = 0.002). Conclusion Women with fibroadenoma (nonproliferative or proliferative) were less likely to progress to BC. Older AA women are at greater risk for progression to breast cancer from BBD.

Keywords

Benign breast disease Progression Risk factors 

Notes

Acknowledgments

This research was supported by NIH CA 70923 (MJW) and ACS EDT-116 (MJW).

Supplementary material

10549_2008_198_MOESM1_ESM.xls (28 kb)
(XLS 28 kb)

References

  1. 1.
    Schnitt SJ (2003) Benign breast disease and breast cancer risk: morphology and beyond. Am J Surg Pathol 27:836–841. doi: 10.1097/00000478-200306000-00017 CrossRefPubMedGoogle Scholar
  2. 2.
    Hartmann LC, Sellers TA, Frost MH, Lingle WL, Degnim AC, Ghosh K, Vierkant RA, Maloney SD, Pankratz VS, Hillman DW, Suman VJ, Johnson J, Blake C, Tlsty T, Vachon CM, Melton LJIII, Visscher DW (2005) Benign breast disease and the risk of breast cancer. N Engl J Med 353:229–237. doi: 10.1056/NEJMoa044383 CrossRefPubMedGoogle Scholar
  3. 3.
    Worsham MJ, Abrams J, Raju U, Kapke A, Lu M, Cheng J, Mott D, Wolman SR (2007) Breast cancer incidence in a cohort of women with benign breast disease from a multiethnic, primary health care population. Breast J 13:115–121. doi: 10.1111/j.1524-4741.2007.00388.x CrossRefPubMedGoogle Scholar
  4. 4.
    Worsham MJ, Raju U, Lu M, Kapke A, Cheng J, Wolman SR (2007) Multiplicity of benign breast lesions is a risk factor for progression to breast cancer. Clin Cancer Res 13:5474–5479. doi: 10.1158/1078-0432.CCR-07-0928 CrossRefPubMedGoogle Scholar
  5. 5.
    Marshall LM, Hunter DJ, Connolly JL, Schnitt SJ, Byrne C, London SJ, Colditz GA (1997) Risk of breast cancer associated with atypical hyperplasia of lobular and ductal types. Cancer Epidemiol Biomarkers Prev 6:297–301PubMedGoogle Scholar
  6. 6.
    Newman LA, Griffith KA, Jatoi I, Simon MS, Crowe JP, Colditz GA (2006) Meta-analysis of survival in African American and white American patients with breast cancer: ethnicity compared with socioeconomic status. J Clin Oncol 24:1342–1349. doi: 10.1200/JCO.2005.03.3472 CrossRefPubMedGoogle Scholar
  7. 7.
    Ghafoor A, Jemal A, Ward E, Cokkinides V, Smith R, Thun M (2003) Trends in breast cancer by race and ethnicity. CA Cancer J Clin 53:342–355CrossRefPubMedGoogle Scholar
  8. 8.
    Sanders ME, Page DL, Simpson JF, Schuyler PA, Dale Plummer W, Dupont WD (2006) Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies. Cancer 106:1453–1461. doi: 10.1002/cncr.21730 CrossRefPubMedGoogle Scholar
  9. 9.
    Degnim AC, Visscher DW, Berman HK, Frost MH, Sellers TA, Vierkant RA, Maloney SD, Pankratz VS, de Groen PC, Lingle WL, Ghosh K, Penheiter L, Tlsty T, Melton LJIII, Reynolds CA, Hartmann LC (2007) Stratification of breast cancer risk in women with atypia: a Mayo cohort study. J Clin Oncol 25:2671–2677. doi: 10.1200/JCO.2006.09.0217 CrossRefPubMedGoogle Scholar
  10. 10.
    Dupont WD, Page DL (1985) Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 312:146–151PubMedGoogle Scholar
  11. 11.
    Krieger N, Hiatt RA (1992) Risk of breast cancer after benign breast diseases. Variation by histologic type, degree of atypia, age at biopsy, and length of follow-up. Am J Epidemiol 135:619–631PubMedGoogle Scholar
  12. 12.
    Carter CL, Corle DK, Micozzi MS, Schatzkin A, Taylor PR (1988) A prospective study of the development of breast cancer in 16,692 women with benign breast disease. Am J Epidemiol 128:467–477PubMedGoogle Scholar
  13. 13.
    London SJ, Connolly JL, Schnitt SJ, Colditz GA (1992) A prospective study of benign breast disease and the risk of breast cancer. JAMA 267:941–944. doi: 10.1001/jama.267.7.941 CrossRefPubMedGoogle Scholar
  14. 14.
    Dupont WD, Parl FF, Hartmann WH, Brinton LA, Winfield AC, Worrell JA, Schuyler PA, Plummer WD (1993) Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer 71:1258–1265. doi:10.1002/1097-0142(19930215)71:4<1258::AID-CNCR2820710415>3.0.CO;2-IGoogle Scholar
  15. 15.
    Dupont WD, Page DL, Parl FF, Plummer WD Jr, Schuyler PA, Kasami M, Jensen RA (1999) Estrogen replacement therapy in women with a history of proliferative breast disease. Cancer 85:1277–1283. doi:10.1002/(SICI)1097-0142(19990315)85:6<1277::AID-CNCR9>3.0.CO;2-EGoogle Scholar
  16. 16.
    Jacobs TW, Byrne C, Colditz G, Connolly JL, Schnitt SJ (1999) Radial scars in benign breast-biopsy specimens and the risk of breast cancer. N Engl J Med 340:430–436. doi: 10.1056/NEJM199902113400604 CrossRefPubMedGoogle Scholar
  17. 17.
    Cheng J, Qiu S, Raju U, Wolman SR, Worsham MJ (2008) Benign breast disease heterogeneity: association with histopathology, age, and ethnicity. Breast Cancer Res Treat 111:289–296. doi: 10.1007/s10549-007-9775-5 CrossRefPubMedGoogle Scholar
  18. 18.
    Ford ME, Hill DD, Blount A, Morrison J, Worsham M, Havstad SL, Johnson CC (2002) Modifying a breast cancer risk factor survey for African American women. Oncol Nurs Forum 29:827–834. doi: 10.1188/02.ONF.827-834 CrossRefPubMedGoogle Scholar
  19. 19.
    Dupont WD, Page DL (1989) Relative risk of breast cancer varies with time since diagnosis of atypical hyperplasia. Hum Pathol 20:723–725. doi: 10.1016/0046-8177(89)90063-4 CrossRefPubMedGoogle Scholar
  20. 20.
    Tamimi RM, Byrne C, Baer HJ, Rosner B, Schnitt SJ, Connolly JL, Colditz GA (2005) Benign breast disease, recent alcohol consumption, and risk of breast cancer: a nested case—control study. Breast Cancer Res 7:R555–R562. doi: 10.1186/bcr1039 CrossRefPubMedGoogle Scholar
  21. 21.
    Cowan DF (1989) H. T. Involution of the breast in women aged 50 to 104 years: a histopathological study of 102 cases. Surg Pathol 2:323–333Google Scholar
  22. 22.
    Hutson SW, Cowen PN, Bird CC (1985) Morphometric studies of age related changes in normal human breast and their significance for evolution of mammary cancer. J Clin Pathol 38:281–287. doi: 10.1136/jcp.38.3.281 CrossRefPubMedGoogle Scholar
  23. 23.
    Milanese TR, Hartmann LC, Sellers TA, Frost MH, Vierkant RA, Maloney SD, Pankratz VS, Degnim AC, Vachon CM, Reynolds CA, Thompson RA, Melton LJIII, Goode EL, Visscher DW (2006) Age-related lobular involution and risk of breast cancer. J Natl Cancer Inst 98:1600–1607PubMedCrossRefGoogle Scholar
  24. 24.
    Henson DE, Tarone RE (1994) Involution and the etiology of breast cancer. Cancer 74:424–429. doi:10.1002/1097-0142(19941001)74:7<1974::AID-CNCR2820740724>3.0.CO;2-0Google Scholar
  25. 25.
    Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD Jr, Rados MS, Schuyler PA (1994) Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med 331:10–15. doi: 10.1056/NEJM199407073310103 CrossRefPubMedGoogle Scholar
  26. 26.
    Foxcroft LM, Evans EB, Porter AJ (2004) The diagnosis of breast cancer in women younger than 40. Breast 13:297–306. doi: 10.1016/j.breast.2004.02.012 CrossRefPubMedGoogle Scholar
  27. 27.
    Markopoulos C, Kouskos E, Mantas D, Kontzoglou K, Antonopoulou K, Revenas Z, Kyriakou V (2004) Fibroadenomas of the breast: is there any association with breast cancer? Eur J Gynaecol Oncol 25:495–497PubMedGoogle Scholar
  28. 28.
    Sklair-Levy M, Sella T, Alweiss T, Craciun I, Libson E, Mally B (2008) Incidence and management of complex fibroadenomas. AJR Am J Roentgenol 190:214–218. doi: 10.2214/AJR.07.2330 CrossRefPubMedGoogle Scholar
  29. 29.
    McDivitt RW, Stevens JA, Lee NC, Wingo PA, Rubin GL, Gersell D (1992) Histologic types of benign breast disease and the risk for breast cancer. The cancer and steroid hormone study group. Cancer 69:1408–1414. doi:10.1002/1097-0142(19920315)69:6<1408::AID-CNCR2820690617>3.0.CO;2-CGoogle Scholar
  30. 30.
    Ashbeck EL, Rosenberg RD, Stauber PM, Key CR (2007) Benign breast biopsy diagnosis and subsequent risk of breast cancer. Cancer Epidemiol Biomarkers Prev 16:467–472. doi: 10.1158/1055-9965.EPI-06-0394 CrossRefPubMedGoogle Scholar
  31. 31.
    Wang DY, Fentiman IS (1985) Epidemiology and endocrinology of benign breast disease. Breast Cancer Res Treat 6:5–36. doi: 10.1007/BF01806008 CrossRefPubMedGoogle Scholar
  32. 32.
    Rohan TE, Jain M, Miller AB (1998) Alcohol consumption and risk of benign proliferative epithelial disorders of the breast: a case–cohort study. Public Health Nutr 1:139–145. doi: 10.1079/PHN19980023 CrossRefPubMedGoogle Scholar
  33. 33.
    Rohan TE, Jain M, Miller AB (1998) A case–cohort study of diet and risk of benign proliferative epithelial disorders of the breast (Canada). Cancer Causes Control 9:19–27. doi: 10.1023/A:1008841118358 CrossRefPubMedGoogle Scholar
  34. 34.
    Brinton LA (1990) Relationship of benign breast disease to breast cancer. Ann N Y Acad Sci 586:266–271. doi: 10.1111/j.1749-6632.1990.tb17815.x CrossRefPubMedGoogle Scholar
  35. 35.
    Thomas DB, Persing JP, Hutchinson WB (1982) Exogenous estrogens and other risk factors for breast cancer in women with benign breast diseases. J Natl Cancer Inst 69:1017–1025PubMedGoogle Scholar
  36. 36.
    Dupont WD, Page DL, Rogers LW, Parl FF (1989) Influence of exogenous estrogens, proliferative breast disease, and other variables on breast cancer risk. Cancer 63:948–957. doi:10.1002/1097-0142(19890301)63:5<948::AID-CNCR2820630527>3.0.CO;2-UGoogle Scholar
  37. 37.
    Byrne C, Connolly JL, Colditz GA, Schnitt SJ (2000) Biopsy confirmed benign breast disease, postmenopausal use of exogenous female hormones, and breast carcinoma risk. Cancer 89:2046–2052. doi:10.1002/1097-0142(20001115)89:10<2046::AID-CNCR3>3.0.CO;2-FGoogle Scholar
  38. 38.
    Rosenberg L, Miller DR, Helmrich SP, Kaufman DW, Schottenfeld D, Stolley PD, Shapiro S (1985) Breast cancer and the consumption of coffee. Am J Epidemiol 122:391–399PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Maria J. Worsham
    • 1
  • Usha Raju
    • 2
  • Mei Lu
    • 3
  • Alissa Kapke
    • 3
  • Alyssa Botttrell
    • 1
    • 4
  • Jingfang Cheng
    • 5
  • Varsha Shah
    • 6
  • Adnan Savera
    • 7
  • Sandra R. Wolman
    • 8
  1. 1.Department of Otolaryngology/Head and Neck SurgeryHenry Ford Health SystemDetroitUSA
  2. 2.Department of PathologyHenry Ford Health SystemDetroitUSA
  3. 3.Department of Biostatistics and Research EpidemiologyHenry Ford Health SystemDetroitUSA
  4. 4.Wayne State UniversityDetroitUSA
  5. 5.Department of Head and Neck SurgeryWayne State School of Medicine, Henry Ford Health SystemDetroitUSA
  6. 6.Royal Gwent HospitalSouth WalesUK
  7. 7.LabMD, Inc.AtlantaUSA
  8. 8.Department of PathologyGeorge Washington UniversityWashingtonUSA

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