title: Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States: a report from the Breast Cancer Surveillance Consortium.
abstract: BACKGROUND
  Current data on the pathologic diagnoses of breast biopsy after mammography can inform patients, clinicians, and researchers about important population trends.
  
  
  METHODS
  Breast Cancer Surveillance Consortium data on 4,020,140 mammograms between 1996 and 2008 were linked to 76,567 pathology specimens. Trends in diagnoses in biopsies by time and risk factors (patient age, breast density, and family history of breast cancer) were examined for screening and diagnostic mammography (performed for a breast symptom or short-interval follow-up).
  
  
  RESULTS
  Of the total mammograms, 88.5% were screening and 11.5% diagnostic; 1.2% of screening and 6.8% of diagnostic mammograms were followed by biopsies. The frequency of biopsies over time was stable after screening mammograms, but increased after diagnostic mammograms. For biopsies obtained after screening, frequencies of invasive carcinoma increased over time for women ages 40-49 and 60-69, Ductal carcinoma in situ (DCIS) increased for those ages 40-69, whereas benign diagnoses decreased for all ages. No trends in pathology diagnoses were found following diagnostic mammograms. Dense breast tissue was associated with high-risk lesions and DCIS relative to nondense breast tissue. Family history of breast cancer was associated with DCIS and invasive cancer.
  
  
  CONCLUSIONS
  Although the frequency of breast biopsy after screening mammography has not changed over time, the percentages of biopsies with DCIS and invasive cancer diagnoses have increased. Among biopsies following mammography, women with dense breasts or family history of breast cancer were more likely to have high-risk lesions or invasive cancer. These findings are relevant to breast cancer screening and diagnostic practices.
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, California.
authors.forename: Kimberly H
authors.initials: KH
authors.lastname: Allison
authors.forename: Linn A
authors.initials: LA
authors.lastname: Abraham
authors.forename: Donald L
authors.initials: DL
authors.lastname: Weaver
authors.forename: Anna N A
authors.initials: AN
authors.lastname: Tosteson
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Nelson
authors.forename: Tracy
authors.initials: T
authors.lastname: Onega
authors.forename: Berta M
authors.initials: BM
authors.lastname: Geller
authors.forename: Karla
authors.initials: K
authors.lastname: Kerlikowske
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Laura E
authors.initials: LE
authors.lastname: Ichikawa
authors.forename: Diana S M
authors.initials: DS
authors.lastname: Buist
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: atypia; breast biopsy; breast cancer diagnosis; breast pathology; ductal carcinoma in situ; false positive; mammography