Benign breast disease, mammographic breast density, and the risk of breast cancer

Jeffrey A. Tice, Ellen S. O'Meara, Donald L. Weaver, Celine M Vachon, Rachel Ballard-Barbash, Karla Kerlikowske

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Background Benign breast disease and high breast density are prevalent, strong risk factors for breast cancer. Women with both risk factors may be at very high risk. Methods We included 42818 women participating in the Breast Cancer Surveillance Consortium who had no prior diagnosis of breast cancer and had undergone at least one benign breast biopsy and mammogram; 1359 women developed incident breast cancer in 6.1 years of follow-up (78.1% invasive, 21.9% ductal carcinoma in situ). We calculated hazard ratios (HRs) using Cox regression analysis. The referent group was women with nonproliferative changes and average density. All P values are two-sided. Results Benign breast disease and breast density were independently associated with breast cancer. The combination of atypical hyperplasia and very high density was uncommon (0.6% of biopsies) but was associated with the highest risk for breast cancer (HR = 5.34; 95% confidence interval [CI] = 3.52 to 8.09, P <. 001). Proliferative disease without atypia (25.6% of biopsies) was associated with elevated risk that varied little across levels of density: average (HR = 1.37; 95% CI = 1.11 to 1.69, P =. 003), high (HR = 2.02; 95% CI = 1.68 to 2.44, P <. 001), or very high (HR = 2.05; 95% CI = 1.54 to 2.72, P <. 001). Low breast density (4.5% of biopsies) was associated with low risk (HRs <1) for all benign pathology diagnoses. Conclusions Women with high breast density and proliferative benign breast disease are at very high risk for future breast cancer. Women with low breast density are at low risk, regardless of their benign pathologic diagnosis.

Original languageEnglish (US)
Pages (from-to)1043-1049
Number of pages7
JournalJournal of the National Cancer Institute
Volume105
Issue number14
DOIs
StatePublished - Jul 17 2013

Fingerprint

Breast Diseases
Breast Neoplasms
Confidence Intervals
Biopsy
Carcinoma, Intraductal, Noninfiltrating
Breast Density
Hyperplasia
Breast
Odds Ratio
Regression Analysis
Pathology

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Tice, J. A., O'Meara, E. S., Weaver, D. L., Vachon, C. M., Ballard-Barbash, R., & Kerlikowske, K. (2013). Benign breast disease, mammographic breast density, and the risk of breast cancer. Journal of the National Cancer Institute, 105(14), 1043-1049. https://doi.org/10.1093/jnci/djt124

Benign breast disease, mammographic breast density, and the risk of breast cancer. / Tice, Jeffrey A.; O'Meara, Ellen S.; Weaver, Donald L.; Vachon, Celine M; Ballard-Barbash, Rachel; Kerlikowske, Karla.

In: Journal of the National Cancer Institute, Vol. 105, No. 14, 17.07.2013, p. 1043-1049.

Research output: Contribution to journalArticle

Tice, JA, O'Meara, ES, Weaver, DL, Vachon, CM, Ballard-Barbash, R & Kerlikowske, K 2013, 'Benign breast disease, mammographic breast density, and the risk of breast cancer', Journal of the National Cancer Institute, vol. 105, no. 14, pp. 1043-1049. https://doi.org/10.1093/jnci/djt124
Tice, Jeffrey A. ; O'Meara, Ellen S. ; Weaver, Donald L. ; Vachon, Celine M ; Ballard-Barbash, Rachel ; Kerlikowske, Karla. / Benign breast disease, mammographic breast density, and the risk of breast cancer. In: Journal of the National Cancer Institute. 2013 ; Vol. 105, No. 14. pp. 1043-1049.
@article{5ec40925c184459d874d7cdec1aff824,
title = "Benign breast disease, mammographic breast density, and the risk of breast cancer",
abstract = "Background Benign breast disease and high breast density are prevalent, strong risk factors for breast cancer. Women with both risk factors may be at very high risk. Methods We included 42818 women participating in the Breast Cancer Surveillance Consortium who had no prior diagnosis of breast cancer and had undergone at least one benign breast biopsy and mammogram; 1359 women developed incident breast cancer in 6.1 years of follow-up (78.1{\%} invasive, 21.9{\%} ductal carcinoma in situ). We calculated hazard ratios (HRs) using Cox regression analysis. The referent group was women with nonproliferative changes and average density. All P values are two-sided. Results Benign breast disease and breast density were independently associated with breast cancer. The combination of atypical hyperplasia and very high density was uncommon (0.6{\%} of biopsies) but was associated with the highest risk for breast cancer (HR = 5.34; 95{\%} confidence interval [CI] = 3.52 to 8.09, P <. 001). Proliferative disease without atypia (25.6{\%} of biopsies) was associated with elevated risk that varied little across levels of density: average (HR = 1.37; 95{\%} CI = 1.11 to 1.69, P =. 003), high (HR = 2.02; 95{\%} CI = 1.68 to 2.44, P <. 001), or very high (HR = 2.05; 95{\%} CI = 1.54 to 2.72, P <. 001). Low breast density (4.5{\%} of biopsies) was associated with low risk (HRs <1) for all benign pathology diagnoses. Conclusions Women with high breast density and proliferative benign breast disease are at very high risk for future breast cancer. Women with low breast density are at low risk, regardless of their benign pathologic diagnosis.",
author = "Tice, {Jeffrey A.} and O'Meara, {Ellen S.} and Weaver, {Donald L.} and Vachon, {Celine M} and Rachel Ballard-Barbash and Karla Kerlikowske",
year = "2013",
month = "7",
day = "17",
doi = "10.1093/jnci/djt124",
language = "English (US)",
volume = "105",
pages = "1043--1049",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "14",

}

TY - JOUR

T1 - Benign breast disease, mammographic breast density, and the risk of breast cancer

AU - Tice, Jeffrey A.

AU - O'Meara, Ellen S.

AU - Weaver, Donald L.

AU - Vachon, Celine M

AU - Ballard-Barbash, Rachel

AU - Kerlikowske, Karla

PY - 2013/7/17

Y1 - 2013/7/17

N2 - Background Benign breast disease and high breast density are prevalent, strong risk factors for breast cancer. Women with both risk factors may be at very high risk. Methods We included 42818 women participating in the Breast Cancer Surveillance Consortium who had no prior diagnosis of breast cancer and had undergone at least one benign breast biopsy and mammogram; 1359 women developed incident breast cancer in 6.1 years of follow-up (78.1% invasive, 21.9% ductal carcinoma in situ). We calculated hazard ratios (HRs) using Cox regression analysis. The referent group was women with nonproliferative changes and average density. All P values are two-sided. Results Benign breast disease and breast density were independently associated with breast cancer. The combination of atypical hyperplasia and very high density was uncommon (0.6% of biopsies) but was associated with the highest risk for breast cancer (HR = 5.34; 95% confidence interval [CI] = 3.52 to 8.09, P <. 001). Proliferative disease without atypia (25.6% of biopsies) was associated with elevated risk that varied little across levels of density: average (HR = 1.37; 95% CI = 1.11 to 1.69, P =. 003), high (HR = 2.02; 95% CI = 1.68 to 2.44, P <. 001), or very high (HR = 2.05; 95% CI = 1.54 to 2.72, P <. 001). Low breast density (4.5% of biopsies) was associated with low risk (HRs <1) for all benign pathology diagnoses. Conclusions Women with high breast density and proliferative benign breast disease are at very high risk for future breast cancer. Women with low breast density are at low risk, regardless of their benign pathologic diagnosis.

AB - Background Benign breast disease and high breast density are prevalent, strong risk factors for breast cancer. Women with both risk factors may be at very high risk. Methods We included 42818 women participating in the Breast Cancer Surveillance Consortium who had no prior diagnosis of breast cancer and had undergone at least one benign breast biopsy and mammogram; 1359 women developed incident breast cancer in 6.1 years of follow-up (78.1% invasive, 21.9% ductal carcinoma in situ). We calculated hazard ratios (HRs) using Cox regression analysis. The referent group was women with nonproliferative changes and average density. All P values are two-sided. Results Benign breast disease and breast density were independently associated with breast cancer. The combination of atypical hyperplasia and very high density was uncommon (0.6% of biopsies) but was associated with the highest risk for breast cancer (HR = 5.34; 95% confidence interval [CI] = 3.52 to 8.09, P <. 001). Proliferative disease without atypia (25.6% of biopsies) was associated with elevated risk that varied little across levels of density: average (HR = 1.37; 95% CI = 1.11 to 1.69, P =. 003), high (HR = 2.02; 95% CI = 1.68 to 2.44, P <. 001), or very high (HR = 2.05; 95% CI = 1.54 to 2.72, P <. 001). Low breast density (4.5% of biopsies) was associated with low risk (HRs <1) for all benign pathology diagnoses. Conclusions Women with high breast density and proliferative benign breast disease are at very high risk for future breast cancer. Women with low breast density are at low risk, regardless of their benign pathologic diagnosis.

UR - http://www.scopus.com/inward/record.url?scp=84880528006&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880528006&partnerID=8YFLogxK

U2 - 10.1093/jnci/djt124

DO - 10.1093/jnci/djt124

M3 - Article

VL - 105

SP - 1043

EP - 1049

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 14

ER -