High prevalence of premalignant lesions in prophylactically removed breasts from women at hereditary risk for breast cancer
| Autor: | Peter Bult, L.M. de Widt-Levert, Nicoline Hoogerbrugge, L.F.A.G. Massuger, Peggy Manders, Han G. Brunner, Lambertus A. Kiemeney, M.J.L. Ligtenberg, Carla Boetes, Louk V.A.M. Beex |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Risk Cancer Research medicine.medical_specialty medicine.medical_treatment Mammary gland Breast Neoplasms Quadrant (abdomen) Breast cancer Age Distribution Interventional oncology [UMCN 1.5] Determinants in Health and Disease [EBP 1] medicine Carcinoma Prevalence Humans Genetic Predisposition to Disease Prospective Studies Prospective cohort study skin and connective tissue diseases Mastectomy Molecular diagnosis prognosis and monitoring [UMCN 1.2] Hyperplasia Endocrinology and reproduction [UMCN 5.2] business.industry Immunotherapy gene therapy and transplantation [UMCN 1.4] Histology Prophylactic Mastectomy Middle Aged medicine.disease Surgery Tumor microenvironment [UMCN 1.3] medicine.anatomical_structure Carcinoma Intraductal Noninfiltrating Genetic defects of metabolism [UMCN 5.1] Oncology ROC Curve Multivariate Analysis Female Radiology business Precancerous Conditions Carcinoma in Situ |
| Zdroj: | Journal of Clinical Oncology, 21, 41-5 Journal of Clinical Oncology, 21, 1, pp. 41-5 |
| ISSN: | 0732-183X |
| Popis: | Contains fulltext : 144389.pdf (Publisher’s version ) (Open Access) PURPOSE: Women with a hereditary predisposition for breast cancer have an extremely high risk of developing invasive breast carcinoma, and many women consider prophylactic mastectomy to avoid this risk. The use of prophylactic mastectomy is still debated. Identification of frequent premalignant lesions in mastectomy specimens would support the preventive concept of prophylactic mastectomy. PATIENTS AND METHODS: We performed a prospective study of breast specimens from 67 women at extremely high genetic risk of breast cancer, with or without previous breast cancer, who were undergoing prophylactic mastectomy (66% were carriers of a BRCA1 or BRCA2 mutation). Breast specimens were studied by radiographic and macroscopic examination of 5-mm tissue slices, with subsequent histology of suspicious lesions and random samples from each quadrant of the breast and the nipple area. RESULTS: In 57% of the women, one or more different types of high-risk histopathologic lesions were present: 37% atypical lobular hyperplasia, 39% atypical ductal hyperplasia, 25% lobular carcinoma-in-situ, and 15% ductal carcinoma-in-situ. A 4-mm invasive ductal carcinoma was found in one woman with ductal carcinoma-in-situ. None of these lesions was detected at palpation or mammography, which were performed before the mastectomy. The presence of high-risk lesions was independently related to age older than 40 years (odds ratio, 6.6; P =.01) and to bilateral oophorectomy before prophylactic mastectomy (odds ratio, 0.2; P = 0.02). CONCLUSION: Many women at high risk of hereditary breast cancer develop high-risk histopathologic lesions, especially after the age of 40 years. Surveillance does not detect such high-risk histopathologic lesions. |
| Databáze: | OpenAIRE |
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