title: Benign breast disease and the risk of subsequent breast cancer in African American women.
abstract: Benign breast disease (BBD) is an established risk factor for breast cancer among Caucasian women but less is known about BBD in African American women. As African American women suffer from disproportionate mortality due to breast cancer, special focus on pathologic characteristics that may influence disease risk is warranted. Benign breast biopsies from African American women were identified by the University Pathology Group (Detroit, MI). African American women of ages 20 to 84 years, who underwent a breast biopsy from 1997 to 2000, were eligible for the study. Subsequent breast cancers were identified through a linkage with the Detroit Surveillance Epidemiology and End Results (SEER) program. The first biopsy was reviewed by the pathologist, and lesions were classified following Dupont and Page criteria along with involution and other histologic features. Logistic regression was used to estimate the risk of developing a subsequent breast cancer with the histologic characteristics of BBD. A total of 1,406 BBD biopsies from African American women were included in this study with a median follow-up of 10.1 years. The majority (68%) showed nonproliferative disease, 29% had proliferative disease without atypia, and 3% had proliferative disease with atypia. Subsequent incident breast cancers occurred in 55 women (3.9%). Women whose biopsies showed proliferative disease with atypia were more than three-fold more likely to develop breast cancer as compared with women who had nonproliferative disease [relative risk (RR) 3.29, 95% confidence interval (CI) 1.21-8.93]. Better characterization of the risk of breast cancer among women with BBD, considering both ethnicity and detailed molecular findings, can lead to better surveillance, earlier diagnosis, and potentially improved survival.
authors.affiliation: Department of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA. cotem@karmanos.org
authors.forename: Michele L
authors.initials: ML
authors.lastname: Cote
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Ruterbusch
authors.forename: Barra
authors.initials: B
authors.lastname: Alosh
authors.forename: Sudeshna
authors.initials: S
authors.lastname: Bandyopadhyay
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kim
authors.forename: Bassam
authors.initials: B
authors.lastname: Albashiti
authors.forename: Bashar
authors.initials: B
authors.lastname: Sharaf Aldeen
authors.forename: Derek C
authors.initials: DC
authors.lastname: Radisky
authors.forename: Marlene H
authors.initials: MH
authors.lastname: Frost
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Visscher
authors.forename: Lynn C
authors.initials: LC
authors.lastname: Hartmann
authors.forename: Warzecha Hind
authors.initials: WH
authors.lastname: Nassar
authors.forename: Rouba
authors.initials: R
authors.lastname: Ali-Femhi
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology*; D049109:Cell Proliferation; D005260:Female; D005348:Fibrocystic Breast Disease / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology*; D006801:Humans; D008824:Michigan; D008875:Middle Aged; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors; D018426:SEER Program