title: Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.
abstract: Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.
authors.affiliation: Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Pg. Marítim 25-29, 08003, Barcelona, Catalonia, Spain, xcastells@hospitaldelmar.cat.
authors.forename: Xavier
authors.initials: X
authors.lastname: Castells
authors.forename: Laia
authors.initials: L
authors.lastname: Domingo
authors.forename: Josep María
authors.initials: JM
authors.lastname: Corominas
authors.forename: Isabel
authors.initials: I
authors.lastname: Torá-Rocamora
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Quintana
authors.forename: Marisa
authors.initials: M
authors.lastname: Baré
authors.forename: Carmen
authors.initials: C
authors.lastname: Vidal
authors.forename: Carmen
authors.initials: C
authors.lastname: Natal
authors.forename: Mar
authors.initials: M
authors.lastname: Sánchez
authors.forename: Francina
authors.initials: F
authors.lastname: Saladié
authors.forename: Joana
authors.initials: J
authors.lastname: Ferrer
authors.forename: Mar
authors.initials: M
authors.lastname: Vernet
authors.forename: Sonia
authors.initials: S
authors.lastname: Servitja
authors.forename: Ana
authors.initials: A
authors.lastname: Rodríguez-Arana
authors.forename: Marta
authors.initials: M
authors.lastname: Roman
authors.forename: Josep Alfons
authors.initials: JA
authors.lastname: Espinàs
authors.forename: María
authors.initials: M
authors.lastname: Sala
mesh_terms: D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors