Markers of Breast Cancer Risk in Women with Benign Breast Disease

摘要

A history of benign breast disease (BBD) is associated with an approximate two-fold increase in risk of breast cancer, however, the risk differs according to the histological characteristics of the benign lesion and other factors. Although histopathology identifies women with BBD with increased risk of breast cancer, such as women with atypical hyperplasia, few women with BBD fall into these high-risk categories and most will not go on to develop breast cancer. In contrast, many women with 'low risk' benign lesions are subsequently diagnosed with breast cancer and for these women, the histopathology of their BBD is not a useful predictor of risk. The purpose of this research was to investigate the relation between prior BBD and subsequent breast cancer in a cohort of women who underwent mammography in a defined population at Group Health Cooperative, a large health maintenance organization in western Washington state. Using a nested case-control design, the project examined the relation between histologic type of BBD and other established risk factors (e.g., age at diagnosis or mammogram, race, family history of breast cancer, menopausal status, use of hormone replacement therapy, and mammographic breast density) with risk of breast cancer. Women were eligible for the study if they underwent mammography at GHC, reported a history of prior breast biopsy at least 1 year prior to their mammogram, and had no history of prior breast cancer. A total of 17,714 women met the study criteria. Of these women, 521 were diagnosed with breast cancer subsequent to their benign biopsy and comprised the 'case' group for the present study. These cases were matched to the pool of the remaining 17,193 women with prior breast biopsy and no subsequent breast cancer on the basis of date of mammogram at Group Health Cooperative using a 1:4 ratio, and compared on the basis of key characteristics.