A multi-center prospective cohort study of benign breast disease and risk of subsequent breast cancer.
OBJECTIVE
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.


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Kabat
Geoffrey C
GC
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA. geoffrey.kabat@einstein.yu.edu
Jones
Joan G
JG
Olson
Neal
N
Negassa
Abdissa
A
Duggan
Catherine
C
Ginsberg
Mindy
M
Kandel
Rita A
RA
Glass
Andrew G
AG
Rohan
Thomas E
TE
D001706:Biopsy / Q000009:adverse effects; D001941:Breast Diseases / Q000150:complications / Q000235:genetics / Q000473:pathology; D001943:Breast Neoplasms / Q000209:etiology* / Q000235:genetics* / Q000473:pathology; D002921:Cicatrix / Q000150:complications / Q000235:genetics / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D018226:Fibroadenoma / Q000150:complications / Q000235:genetics / Q000473:pathology; D005348:Fibrocystic Breast Disease / Q000150:complications / Q000235:genetics / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia / Q000150:complications; D016015:Logistic Models; D016017:Odds Ratio; D010212:Papilloma / Q000150:complications / Q000235:genetics / Q000473:pathology; D011230:Precancerous Conditions / Q000150:complications / Q000235:genetics / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors