Benign breast disease and the risk of breast cancer

Lynn C. Hartmann, Thomas A. Sellers, Marlene H. Frost, Wilma L. Lingle, Amy C Degnim, Karthik Ghosh, Robert A. Vierkant, Shaun D. Maloney, V. Shane Pankratz, David W. Hillman, Vera Jean Suman, Jo Johnson, Cassann Blake, Thea Tlsty, Celine M Vachon, L. Joseph Melton, Daniel W Visscher

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Benign breast disease is an important risk factor for breast cancer. We studied a large group of women with benign breast disease to obtain reliable estimates of this risk. METHODS: We identified all women who received a diagnosis of benign breast disease at the Mayo Clinic between 1967 and 1991. Breast-cancer events were obtained from medical records and questionnaires. To estimate relative risks, we compared the number of observed breast cancers with the number expected on the basis of the rates of breast cancer in the Iowa Surveillance, Epidemiology, and End Results registry. RESULTS: We followed 9087 women for a median of 15 years. The histologic findings were nonproliferative lesions in 67 percent of women, proliferative lesions without atypia in 30 percent, and atypical hyperplasia in 4 percent. To date, 707 breast cancers have developed. The relative risk of breast cancer for the cohort was 1.56 (95 percent confidence interval, 1.45 to 1.68), and this increased risk persisted for at least 25 years after biopsy. The relative risk associated with atypia was 4.24 (95 percent confidence interval, 3.26 to 5.41), as compared with a relative risk of 1.88 (95 percent confidence interval, 1.66 to 2.12) for proliferative changes without atypia and of 1.27 (95 percent confidence interval, 1.15 to 1.41) for nonproliferative lesions. The strength of the family history of breast cancer, available for 4808 women, was a risk factor that was independent of histologic findings. No increased risk was found among women with no family history and nonproliferative findings. In the first 10 years after the initial biopsy, an excess of cancers occurred in the same breast, especially in women with atypia. CONCLUSIONS: Risk factors for breast cancer after the diagnosis of benign breast disease include the histologic classification of a benign breast lesion and a family history of breast cancer.

Original languageEnglish (US)
Pages (from-to)229-237
Number of pages9
JournalNew England Journal of Medicine
Volume353
Issue number3
DOIs
StatePublished - Jul 21 2005

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Breast Diseases
Breast Neoplasms
Confidence Intervals
Breast
Biopsy
Hyperplasia
Medical Records
Registries
Epidemiology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Benign breast disease and the risk of breast cancer. / Hartmann, Lynn C.; Sellers, Thomas A.; Frost, Marlene H.; Lingle, Wilma L.; Degnim, Amy C; Ghosh, Karthik; Vierkant, Robert A.; Maloney, Shaun D.; Pankratz, V. Shane; Hillman, David W.; Suman, Vera Jean; Johnson, Jo; Blake, Cassann; Tlsty, Thea; Vachon, Celine M; Melton, L. Joseph; Visscher, Daniel W.

In: New England Journal of Medicine, Vol. 353, No. 3, 21.07.2005, p. 229-237.

Research output: Contribution to journalArticle

Hartmann, LC, Sellers, TA, Frost, MH, Lingle, WL, Degnim, AC, Ghosh, K, Vierkant, RA, Maloney, SD, Pankratz, VS, Hillman, DW, Suman, VJ, Johnson, J, Blake, C, Tlsty, T, Vachon, CM, Melton, LJ & Visscher, DW 2005, 'Benign breast disease and the risk of breast cancer' New England Journal of Medicine, vol. 353, no. 3, pp. 229-237. https://doi.org/10.1056/NEJMoa044383
Hartmann, Lynn C. ; Sellers, Thomas A. ; Frost, Marlene H. ; Lingle, Wilma L. ; Degnim, Amy C ; Ghosh, Karthik ; Vierkant, Robert A. ; Maloney, Shaun D. ; Pankratz, V. Shane ; Hillman, David W. ; Suman, Vera Jean ; Johnson, Jo ; Blake, Cassann ; Tlsty, Thea ; Vachon, Celine M ; Melton, L. Joseph ; Visscher, Daniel W. / Benign breast disease and the risk of breast cancer. In: New England Journal of Medicine. 2005 ; Vol. 353, No. 3. pp. 229-237.
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abstract = "BACKGROUND: Benign breast disease is an important risk factor for breast cancer. We studied a large group of women with benign breast disease to obtain reliable estimates of this risk. METHODS: We identified all women who received a diagnosis of benign breast disease at the Mayo Clinic between 1967 and 1991. Breast-cancer events were obtained from medical records and questionnaires. To estimate relative risks, we compared the number of observed breast cancers with the number expected on the basis of the rates of breast cancer in the Iowa Surveillance, Epidemiology, and End Results registry. RESULTS: We followed 9087 women for a median of 15 years. The histologic findings were nonproliferative lesions in 67 percent of women, proliferative lesions without atypia in 30 percent, and atypical hyperplasia in 4 percent. To date, 707 breast cancers have developed. The relative risk of breast cancer for the cohort was 1.56 (95 percent confidence interval, 1.45 to 1.68), and this increased risk persisted for at least 25 years after biopsy. The relative risk associated with atypia was 4.24 (95 percent confidence interval, 3.26 to 5.41), as compared with a relative risk of 1.88 (95 percent confidence interval, 1.66 to 2.12) for proliferative changes without atypia and of 1.27 (95 percent confidence interval, 1.15 to 1.41) for nonproliferative lesions. The strength of the family history of breast cancer, available for 4808 women, was a risk factor that was independent of histologic findings. No increased risk was found among women with no family history and nonproliferative findings. In the first 10 years after the initial biopsy, an excess of cancers occurred in the same breast, especially in women with atypia. CONCLUSIONS: Risk factors for breast cancer after the diagnosis of benign breast disease include the histologic classification of a benign breast lesion and a family history of breast cancer.",
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T1 - Benign breast disease and the risk of breast cancer

AU - Hartmann, Lynn C.

AU - Sellers, Thomas A.

AU - Frost, Marlene H.

AU - Lingle, Wilma L.

AU - Degnim, Amy C

AU - Ghosh, Karthik

AU - Vierkant, Robert A.

AU - Maloney, Shaun D.

AU - Pankratz, V. Shane

AU - Hillman, David W.

AU - Suman, Vera Jean

AU - Johnson, Jo

AU - Blake, Cassann

AU - Tlsty, Thea

AU - Vachon, Celine M

AU - Melton, L. Joseph

AU - Visscher, Daniel W

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N2 - BACKGROUND: Benign breast disease is an important risk factor for breast cancer. We studied a large group of women with benign breast disease to obtain reliable estimates of this risk. METHODS: We identified all women who received a diagnosis of benign breast disease at the Mayo Clinic between 1967 and 1991. Breast-cancer events were obtained from medical records and questionnaires. To estimate relative risks, we compared the number of observed breast cancers with the number expected on the basis of the rates of breast cancer in the Iowa Surveillance, Epidemiology, and End Results registry. RESULTS: We followed 9087 women for a median of 15 years. The histologic findings were nonproliferative lesions in 67 percent of women, proliferative lesions without atypia in 30 percent, and atypical hyperplasia in 4 percent. To date, 707 breast cancers have developed. The relative risk of breast cancer for the cohort was 1.56 (95 percent confidence interval, 1.45 to 1.68), and this increased risk persisted for at least 25 years after biopsy. The relative risk associated with atypia was 4.24 (95 percent confidence interval, 3.26 to 5.41), as compared with a relative risk of 1.88 (95 percent confidence interval, 1.66 to 2.12) for proliferative changes without atypia and of 1.27 (95 percent confidence interval, 1.15 to 1.41) for nonproliferative lesions. The strength of the family history of breast cancer, available for 4808 women, was a risk factor that was independent of histologic findings. No increased risk was found among women with no family history and nonproliferative findings. In the first 10 years after the initial biopsy, an excess of cancers occurred in the same breast, especially in women with atypia. CONCLUSIONS: Risk factors for breast cancer after the diagnosis of benign breast disease include the histologic classification of a benign breast lesion and a family history of breast cancer.

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