A multi-center prospective cohort study of benign breast disease and risk of subsequent breast cancer
We used a nested case–control design within a large, multi-center cohort of women who underwent a biopsy for benign breast disease (BBD) to assess the association of broad histologic groupings and specific histologic entities with risk of breast cancer.
Cases were all women who had a biopsy for BBD and who subsequently developed breast cancer; controls were individually matched to cases and were women with a biopsy for BBD who did not develop breast cancer in the same follow-up interval as that for the cases. After exclusions, 1,239 records (615 cases and 624 controls) were available for analysis. We used conditional logistic regression to estimate odds ratios and 95% confidence intervals (CIs).
Relative to non-proliferative BBD/normal pathology, the multivariable-adjusted odds ratio for proliferative lesions without atypia was 1.45 (95% CI 1.10–1.90), and that for atypical hyperplasia was 5.27 (95% CI 2.29–12.15). The presence of multiple foci of columnar cell hyperplasia and of complex fibroadenoma without atypia was associated with a non-significantly increased risk of breast cancer, whereas sclerosing adenosis, radial scar, and papilloma showed no association with risk.
Our results indicate that, compared to women with normal pathology/non-proliferative disease, women with proliferative disease without atypia have a modestly increased risk of breast cancer, whereas women with atypical hyperplasia have a substantially increased risk.
KeywordsBenign breast disease Proliferative disease Atypical hyperplasia Breast cancer
We thank Emily Harris for her contributions to the development of this study, and we also thank Victor Kamensky for his programming and database management support. This study was supported by NIH: RO1-CA95661-01 “p53 in BBD and breast cancer risk: a multicenter cohort.”
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