Current Breast Cancer Reports

, Volume 1, Issue 3, pp 167–174

Refining risk assessment in women with atypical hyperplasia

Article

Abstract

Atypical hyperplasia (AH) is associated with an approximate fourfold increase in breast cancer risk. Although this increase in risk is significant, the majority of women with AH will not develop breast cancer. Current breast cancer risk prediction models are unable to provide accurate risk estimates for individuals with AH. Tamoxifen offers a substantive risk reduction for women with AH, but its profile of risks and side effects limits its acceptance and widespread use. Therefore, additional differentiation of breast cancer risk among women with AH is desirable. In addition to clinical factors (ie, age at AH diagnosis), recently investigated histologic features and molecular markers of an individual’s breast tissue show promise as features that further differentiate breast cancer risk in women with AH.

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References and Recommended Reading

  1. 1.
    Dupont WD, Page DL: Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 1985, 312:146–151.PubMedGoogle Scholar
  2. 2.
    Carter CL, Corle DK, Micozzi MS, et al.: A prospective study of the development of breast cancer in 16,692 women with benign breast disease. Am J Epidemiol 1988, 128:467–477.PubMedGoogle Scholar
  3. 3.
    London SJ, Connolly JL, Schnitt SJ, Colditz GA: A prospective study of benign breast disease and the risk of breast cancer. JAMA 1992, 267:941–944.PubMedCrossRefGoogle Scholar
  4. 4.
    Krieger N, Hiatt RA: 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 1992, 135:619–631.PubMedGoogle Scholar
  5. 5.
    Fabian CJ, Kimler BF, Zalles CM, et al.: Short-term breast cancer prediction by random periareolar fine-needle aspiration cytology and the Gail risk model. J Natl Cancer Inst 2000, 2:1217–1227.CrossRefGoogle Scholar
  6. 6.
    Wrensch MR, Petrakis NL, Miike R, et al.: Breast cancer risk in women with abnormal cytology in nipple aspirates of breast fluid. J Natl Cancer Inst 2001, 93:1791–1798.PubMedCrossRefGoogle Scholar
  7. 7.
    Hartmann LC, Sellers TA, Frost MH, et al.: Benign breast disease and the risk of breast cancer. N Engl J Med 2005, 353:229–237.PubMedCrossRefGoogle Scholar
  8. 8.
    Page DL, Dupont WD, Rogers LW, et al.: Atypical hyperplastic lesions of the female breast: a long-term follow-up study. Cancer 1985, 55:2698–2708.PubMedCrossRefGoogle Scholar
  9. 9.
    Page DL, Rogers LW: Combined histologic and cytologic criteria for the diagnosis of mammary atypical ductal hyperplasia. Hum Pathol 1992, 23:1095–1097.PubMedCrossRefGoogle Scholar
  10. 10.
    Sloane JP, Amendoeira I, Apostolikas N, et al.: Consistency achieved by 23 European pathologists from 12 countries in diagnosing breast disease and reporting prognostic features of carcinomas. Virchows Arch 1999, 434:3–10.PubMedCrossRefGoogle Scholar
  11. 11.
    Schnitt SJ, Connolly JL, Tavassoli FA, et al.: Interobserver reproducibility in the diagnosis of ductal proliferative breast lesions using standardized criteria. Am J Surg Pathol 1992, 16:1133–1143.PubMedCrossRefGoogle Scholar
  12. 12.
    Gail MH, Brinton LA, Byar DP, et al.: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 1989, 81:1879–1886.PubMedCrossRefGoogle Scholar
  13. 13.
    Elmore JG, Fletcher SW: The risk of cancer risk prediction: “What is my risk of getting breast cancer?” J Natl Cancer Inst 2006, 98:1673–1675.PubMedCrossRefGoogle Scholar
  14. 14.
    Rockhill B, Spiegelman D, Byrne C, et al.: Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention. J Natl Cancer Inst 2001, 93:358–366.PubMedCrossRefGoogle Scholar
  15. 15.
    Pankratz VS, Hartmann LC, Degnim AC, et al.: Assessment of the accuracy of the Gail model in women with atypical hyperplasia. J Clin Oncol 2008, 26:5374–5379.PubMedCrossRefGoogle Scholar
  16. 16.
    Tyrer J, Duffy SW, Cuzick J: A breast cancer prediction model incorporating familial and personal risk factors. Statist Med 2004, 23:1111–1130.CrossRefGoogle Scholar
  17. 17.
    Amir E, Evans DG, Shenton A, et al.: Evaluation of breast cancer risk assessment packages in the family history evaluation and screening programme. J Med Genet 2003, 40:807–814.PubMedCrossRefGoogle Scholar
  18. 18.
    Fisher B, Costantino JP, Wickerham DL, et al.: Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998, 90:1371–1388.PubMedCrossRefGoogle Scholar
  19. 19.
    Port ER, Montgomery LL, Heerdt AS, Borgen PL: Patient reluctance toward tamoxifen use for breast cancer primary prevention. Ann Surg Oncol 2001, 8:580–585.PubMedCrossRefGoogle Scholar
  20. 20.
    Degnim AC, Visscher DW, Berman HK, et al.: Stratification of breast cancer risk in women with atypia: a Mayo cohort study. J Clin Oncol 2007, 25:2671–2677.PubMedCrossRefGoogle Scholar
  21. 21.
    Collins LC, Baer HJ, Tamimi RM, et al.: The influence of family history on breast cancer risk in women with biopsy-confirmed benign breast disease. Results from the Nurses’ Health Study. Cancer 2006, 107:1240–1247.PubMedCrossRefGoogle Scholar
  22. 22.
    Collins LC, Baer HJ, Tamimi RM, et al.: Magnitude and laterality of breast cancer risk according to histologic type of atypical hyperplasia. Results from the Nurses’ Health Study. Cancer 2007, 109:180–187.PubMedCrossRefGoogle Scholar
  23. 23.
    Marshall LM, Hunter DJ, Connolly JL, et al.: Risk of breast cancer associated with atypical hyperplasia of lobular and ductal types. Cancer Epidemiol Biomarkers Prev 1997, 6:297–301.PubMedGoogle Scholar
  24. 24.
    Page DL, Schuyler PA, Dupont WD, et al.: Atypical lobular hyperplasia as a unilateral predictor of breast cancer risk: a retrospective cohort study. Lancet 2003, 361:125–129.PubMedCrossRefGoogle Scholar
  25. 25.
    Dupont WD, Page DL: Relative risk of breast cancer varies with time since diagnosis of atypical hyperplasia. Hum Pathol 1989, 21:723–725.CrossRefGoogle Scholar
  26. 26.
    Milanese TR, Hartmann LC, Sellers TA, et al.: Age-related lobular involution and risk of breast cancer. J Natl Cancer Inst 2006, 98:1600–1607.PubMedGoogle Scholar
  27. 27.
    McLaren BK, Schuyler PA, Sanders ME, et al.: Excellent survival, cancer type, and Notthingham grade after atypical lobular hyperplasia on initial breast biopsy. Cancer 2006, 107:1227–1233.PubMedCrossRefGoogle Scholar
  28. 28.
    Moulis S, Sgroi DC: Re-evaluating early breast neoplasia. Breast Cancer Res 2008, 10:302.PubMedCrossRefGoogle Scholar
  29. 29.
    Ma X-J, Salunga R, Tuggle JT, et al.: Gene expression profiles of human breast cancer progression. Proc Natl Acad Sci USA 2003, 100:5974–5979.PubMedCrossRefGoogle Scholar
  30. 30.
    Petroff BK, Phillips TA, Kimler BF, Fabian CJ: Detection of biomarker gene expression by real-time polymerase chain reaction using amplified ribonucleic acids from formalin-fixed random periareolar fine needle aspirates of human breast tissue. Anal Quant Cytol Histol 2006, 28:297–302.PubMedGoogle Scholar
  31. 31.
    Ristimäki A, Sivula A, Lundin J, et al.: Prognostic significance of elevated cyclooxygenase-2 expression in breast cancer. Cancer Res 2002, 62:632–635.PubMedGoogle Scholar
  32. 32.
    Shim V, Gauthier ML, Sudilovsky D, et al.: Cyclooxygenase-2 expression is related to nuclear grade in ductal carcinoma in situ and is increased in its normal adjacent epithelium. Cancer Res 2003, 63:2347–2350.PubMedGoogle Scholar
  33. 33.
    Visscher DW, Pankratz VS, Santisteban M, et al.: Association between cyclooxygenase-2 expression in atypical hyperplasia and risk of breast cancer. J Natl Cancer Inst 2008, 100:421–427.PubMedCrossRefGoogle Scholar
  34. 34.
    Gobbi H, Dupont WD, Simpson JF, et al.: Transforming growth factor-beta and breast cancer risk in women with mammary epithelial hyperplasia. J Natl Cancer Inst 1999, 91:2096–2101.PubMedCrossRefGoogle Scholar
  35. 35.
    Shaaban AM, Sloane JP, West CR, Foster CS: Breast cancer risk in usual ductal hyperplasia is defined by estrogen receptor-alpha and Ki-67 expression. Am J Pathol 2002, 160:597–604.PubMedGoogle Scholar
  36. 36.
    Khan QJ, Kimler BF, Clark J, et al.: Ki-67 expression in benign breast ductal cells obtained by random periareolar fine needle aspiration. Cancer Epidemiol Biomarkers Prev 2005, 14:786–789.PubMedCrossRefGoogle Scholar
  37. 37.
    Santisteban M, Reynolds C, Barr Fritcher EG, et al.: Ki67: a time varying biomarker of risk of breast cancer in atypical hyperplasia. Presented at the 32nd Annual San Antonio Breast Cancer Symposium. San Antonio, TX; December 9–13, 2009.Google Scholar
  38. 38.
    Bean GR, Bryson AD, Pilie PG, et al.: Morphologically normal-appearing mammary epithelial cells obtained from high-risk women exhibit methylation silencing of INK4a/ARF. Clin Cancer Res 2007, 13:6834–6841.PubMedCrossRefGoogle Scholar
  39. 39.
    Poola I, DeWitty RL, Marshalleck JJ, et al.: Identification of MMP-1 as a putative breast cancer predictive marker by global gene expression analysis. Nat Med 2005, 11:481–483.PubMedCrossRefGoogle Scholar
  40. 40.
    Poola I, Shokrani B, Bhatnagar R, et al.: Expression of carcinoembryonic antigen cell adhesion molecule 6 oncoprotein in atypical hyperplastic tissues is associated with the development of invasive breast cancer. Clin Cancer Res 2006, 12:4773–4783.PubMedCrossRefGoogle Scholar
  41. 41.
    Poola I, Abraham J, Marshalleck JJ, et al.: Molecular risk assessment for breast cancer development in patients with ductal hyperplasias. Clin Cancer Res 2008, 14:1274–1280.PubMedCrossRefGoogle Scholar
  42. 42.
    Hojilla CV, Mohammed FF, Khokha R: Matrix metalloproteinases and their tissue inhibitors direct cell fate during cancer development. Br J Cancer 2003, 89:1817–1821.PubMedCrossRefGoogle Scholar
  43. 43.
    Lacroix M, Zammatteo N, Remacle J, Leclercq G: A low density DNA microarray for analysis of markers in breast cancer. Int J Biol Markers 2002, 17:5–23.PubMedGoogle Scholar

Copyright information

© Current Medicine Group, LLC 2009

Authors and Affiliations

  1. 1.Department of SurgeryMayo ClinicRochesterUSA

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