Benign Breast Disease and the Risk of Breast Cancer
| Autor: | Vera J. Suman, Karthik Ghosh, Cassann Blake, Celine M. Vachon, Daniel W. Visscher, Lynn C. Hartmann, Thea D. Tlsty, V. Shane Pankratz, Robert A. Vierkant, Wilma L. Lingle, Amy C. Degnim, L. Joseph Melton, Jo Johnson, David W. Hillman, Thomas A. Sellers, Shaun D. Maloney, Marlene H. Frost |
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| Rok vydání: | 2016 |
| Předmět: |
CA15-3
Oncology Medical and Health Sciences Atypical hyperplasia Cohort Studies Breast Diseases 0302 clinical medicine Atypia Breast Family history Age of Onset skin and connective tissue diseases Fibrocystic Breast Disease Cancer Obstetrics Obstetrics and Gynecology General Medicine Middle Aged Risk factors for breast cancer 030220 oncology & carcinogenesis Female Patient Safety Breast disease Risk Adult medicine.medical_specialty Breast Neoplasms 030209 endocrinology & metabolism Paediatrics and Reproductive Medicine 03 medical and health sciences Breast cancer Clinical Research General & Internal Medicine Internal medicine Breast Cancer medicine Humans Risk factor Obstetrics & Reproductive Medicine Proportional Hazards Models Aged Gynecology Hyperplasia business.industry Prevention medicine.disease Relative risk business |
| Zdroj: | The New England journal of medicine, vol 353, iss 3 Obstetrical & Gynecological Survey, vol 71, iss 8 Obstetrical and Gynecological Survey, vol 71, iss 8 |
| ISSN: | 0029-7828 |
| DOI: | 10.1097/01.ogx.0000489578.68399.d7 |
| Popis: | BACKGROUND Benign breast disease is an important risk factor for breast cancer. We studied a large group of women with benign breast disease to obtain reliable estimates of this risk. METHODS We identified all women who received a diagnosis of benign breast disease at the Mayo Clinic between 1967 and 1991. Breast-cancer events were obtained from medical records and questionnaires. To estimate relative risks, we compared the number of observed breast cancers with the number expected on the basis of the rates of breast cancer in the Iowa Surveillance, Epidemiology, and End Results registry. RESULTS We followed 9087 women for a median of 15 years. The histologic findings were nonproliferative lesions in 67 percent of women, proliferative lesions without atypia in 30 percent, and atypical hyperplasia in 4 percent. To date, 707 breast cancers have developed. The relative risk of breast cancer for the cohort was 1.56 (95 percent confidence interval, 1.45 to 1.68), and this increased risk persisted for at least 25 years after biopsy. The relative risk associated with atypia was 4.24 (95 percent confidence interval, 3.26 to 5.41), as compared with a relative risk of 1.88 (95 percent confidence interval, 1.66 to 2.12) for proliferative changes without atypia and of 1.27 (95 percent confidence interval, 1.15 to 1.41) for nonproliferative lesions. The strength of the family history of breast cancer, available for 4808 women, was a risk factor that was independent of histologic findings. No increased risk was found among women with no family history and nonproliferative findings. In the first 10 years after the initial biopsy, an excess of cancers occurred in the same breast, especially in women with atypia. CONCLUSIONS Risk factors for breast cancer after the diagnosis of benign breast disease include the histologic classification of a benign breast lesion and a family history of breast cancer. |
| Databáze: | OpenAIRE |
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