Clinicopathologic features of breast cancers that develop in women with previous benign breast disease

Daniel W Visscher, Marlene H. Frost, Lynn C. Hartmann, Ryan D. Frank, Robert A. Vierkant, Ann E. Mccullough, Stacey J Winham, Celine M Vachon, Karthik Ghosh, Kathleen R Brandt, Ann M. Farrell, Yaman Tarabishy, Tina J Hieken, Tufia C Haddad, Ruth A. Kraft, Derek C Radisky, Amy C Degnim

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

BACKGROUND: Women with benign breast disease (BBD) have an increased risk of developing breast cancer (BC). Nearly 30% of all BCs develop in women with prior BBD. Information regarding features of the expected number of BCs after BBD would enhance individualized surveillance and prevention strategies for these women. In the current study, the authors sought to characterize BCs developing in a large cohort of women with BBD. METHODS: The current study cohort included 13,485 women who underwent breast biopsy for mammographic or palpable concerns between 1967 and 2001. Biopsy slides were reviewed and classified as nonproliferative disease, proliferative disease without atypia, or atypical hyperplasia. BCs were identified by follow-up questionnaires, medical records, and Tumor Registry data. BC tissues were obtained and reviewed. RESULTS: With median follow-up of 15.8 years, 1273 women developed BC. The majority of BCs were invasive (81%), of which 61% were ductal, 13% were mixed ductal/lobular, and 14% were lobular. Approximately two-thirds of the BC cases were intermediate or high grade, and 29% were lymph node positive. Cancer characteristics were similar across the 3 histologic categories of BBD, with a similar frequency of ductal carcinoma in situ, invasive disease, tumor size, time to invasive BC, histologic type of BC, lymph node positivity, and human epidermal growth factor receptor 2 positivity. Women with atypical hyperplasia were found to have a higher frequency of estrogen receptor-positive BC (91%) compared with women with proliferative disease without atypia (80%) or nonproliferative disease (85%) (P=.02). CONCLUSIONS: A substantial percentage of all BCs develop in women with prior BBD. The majority of BCs after BBD are invasive tumors of ductal type, with a substantial number demonstrating lymph node positivity. Of all the BCs in the current study, 84% were estrogen receptor positive. Prevention therapy should be strongly encouraged in higher-risk women with BBD.

Original languageEnglish (US)
JournalCancer
DOIs
StateAccepted/In press - 2015

Fingerprint

Breast Diseases
Breast Neoplasms
Lymph Nodes
Estrogen Receptors
Hyperplasia
Neoplasms
Biopsy
Carcinoma, Intraductal, Noninfiltrating
Medical Records
Registries
Breast
Cohort Studies

Keywords

  • Atypical hyperplasia
  • Benign breast disease
  • Breast cancer features
  • Breast cancer risk
  • Risk
  • Tumor characteristics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Clinicopathologic features of breast cancers that develop in women with previous benign breast disease. / Visscher, Daniel W; Frost, Marlene H.; Hartmann, Lynn C.; Frank, Ryan D.; Vierkant, Robert A.; Mccullough, Ann E.; Winham, Stacey J; Vachon, Celine M; Ghosh, Karthik; Brandt, Kathleen R; Farrell, Ann M.; Tarabishy, Yaman; Hieken, Tina J; Haddad, Tufia C; Kraft, Ruth A.; Radisky, Derek C; Degnim, Amy C.

In: Cancer, 2015.

Research output: Contribution to journalArticle

@article{f9b7dc5e4b3f45fd8fd834917e656010,
title = "Clinicopathologic features of breast cancers that develop in women with previous benign breast disease",
abstract = "BACKGROUND: Women with benign breast disease (BBD) have an increased risk of developing breast cancer (BC). Nearly 30{\%} of all BCs develop in women with prior BBD. Information regarding features of the expected number of BCs after BBD would enhance individualized surveillance and prevention strategies for these women. In the current study, the authors sought to characterize BCs developing in a large cohort of women with BBD. METHODS: The current study cohort included 13,485 women who underwent breast biopsy for mammographic or palpable concerns between 1967 and 2001. Biopsy slides were reviewed and classified as nonproliferative disease, proliferative disease without atypia, or atypical hyperplasia. BCs were identified by follow-up questionnaires, medical records, and Tumor Registry data. BC tissues were obtained and reviewed. RESULTS: With median follow-up of 15.8 years, 1273 women developed BC. The majority of BCs were invasive (81{\%}), of which 61{\%} were ductal, 13{\%} were mixed ductal/lobular, and 14{\%} were lobular. Approximately two-thirds of the BC cases were intermediate or high grade, and 29{\%} were lymph node positive. Cancer characteristics were similar across the 3 histologic categories of BBD, with a similar frequency of ductal carcinoma in situ, invasive disease, tumor size, time to invasive BC, histologic type of BC, lymph node positivity, and human epidermal growth factor receptor 2 positivity. Women with atypical hyperplasia were found to have a higher frequency of estrogen receptor-positive BC (91{\%}) compared with women with proliferative disease without atypia (80{\%}) or nonproliferative disease (85{\%}) (P=.02). CONCLUSIONS: A substantial percentage of all BCs develop in women with prior BBD. The majority of BCs after BBD are invasive tumors of ductal type, with a substantial number demonstrating lymph node positivity. Of all the BCs in the current study, 84{\%} were estrogen receptor positive. Prevention therapy should be strongly encouraged in higher-risk women with BBD.",
keywords = "Atypical hyperplasia, Benign breast disease, Breast cancer features, Breast cancer risk, Risk, Tumor characteristics",
author = "Visscher, {Daniel W} and Frost, {Marlene H.} and Hartmann, {Lynn C.} and Frank, {Ryan D.} and Vierkant, {Robert A.} and Mccullough, {Ann E.} and Winham, {Stacey J} and Vachon, {Celine M} and Karthik Ghosh and Brandt, {Kathleen R} and Farrell, {Ann M.} and Yaman Tarabishy and Hieken, {Tina J} and Haddad, {Tufia C} and Kraft, {Ruth A.} and Radisky, {Derek C} and Degnim, {Amy C}",
year = "2015",
doi = "10.1002/cncr.29766",
language = "English (US)",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Clinicopathologic features of breast cancers that develop in women with previous benign breast disease

AU - Visscher, Daniel W

AU - Frost, Marlene H.

AU - Hartmann, Lynn C.

AU - Frank, Ryan D.

AU - Vierkant, Robert A.

AU - Mccullough, Ann E.

AU - Winham, Stacey J

AU - Vachon, Celine M

AU - Ghosh, Karthik

AU - Brandt, Kathleen R

AU - Farrell, Ann M.

AU - Tarabishy, Yaman

AU - Hieken, Tina J

AU - Haddad, Tufia C

AU - Kraft, Ruth A.

AU - Radisky, Derek C

AU - Degnim, Amy C

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Women with benign breast disease (BBD) have an increased risk of developing breast cancer (BC). Nearly 30% of all BCs develop in women with prior BBD. Information regarding features of the expected number of BCs after BBD would enhance individualized surveillance and prevention strategies for these women. In the current study, the authors sought to characterize BCs developing in a large cohort of women with BBD. METHODS: The current study cohort included 13,485 women who underwent breast biopsy for mammographic or palpable concerns between 1967 and 2001. Biopsy slides were reviewed and classified as nonproliferative disease, proliferative disease without atypia, or atypical hyperplasia. BCs were identified by follow-up questionnaires, medical records, and Tumor Registry data. BC tissues were obtained and reviewed. RESULTS: With median follow-up of 15.8 years, 1273 women developed BC. The majority of BCs were invasive (81%), of which 61% were ductal, 13% were mixed ductal/lobular, and 14% were lobular. Approximately two-thirds of the BC cases were intermediate or high grade, and 29% were lymph node positive. Cancer characteristics were similar across the 3 histologic categories of BBD, with a similar frequency of ductal carcinoma in situ, invasive disease, tumor size, time to invasive BC, histologic type of BC, lymph node positivity, and human epidermal growth factor receptor 2 positivity. Women with atypical hyperplasia were found to have a higher frequency of estrogen receptor-positive BC (91%) compared with women with proliferative disease without atypia (80%) or nonproliferative disease (85%) (P=.02). CONCLUSIONS: A substantial percentage of all BCs develop in women with prior BBD. The majority of BCs after BBD are invasive tumors of ductal type, with a substantial number demonstrating lymph node positivity. Of all the BCs in the current study, 84% were estrogen receptor positive. Prevention therapy should be strongly encouraged in higher-risk women with BBD.

AB - BACKGROUND: Women with benign breast disease (BBD) have an increased risk of developing breast cancer (BC). Nearly 30% of all BCs develop in women with prior BBD. Information regarding features of the expected number of BCs after BBD would enhance individualized surveillance and prevention strategies for these women. In the current study, the authors sought to characterize BCs developing in a large cohort of women with BBD. METHODS: The current study cohort included 13,485 women who underwent breast biopsy for mammographic or palpable concerns between 1967 and 2001. Biopsy slides were reviewed and classified as nonproliferative disease, proliferative disease without atypia, or atypical hyperplasia. BCs were identified by follow-up questionnaires, medical records, and Tumor Registry data. BC tissues were obtained and reviewed. RESULTS: With median follow-up of 15.8 years, 1273 women developed BC. The majority of BCs were invasive (81%), of which 61% were ductal, 13% were mixed ductal/lobular, and 14% were lobular. Approximately two-thirds of the BC cases were intermediate or high grade, and 29% were lymph node positive. Cancer characteristics were similar across the 3 histologic categories of BBD, with a similar frequency of ductal carcinoma in situ, invasive disease, tumor size, time to invasive BC, histologic type of BC, lymph node positivity, and human epidermal growth factor receptor 2 positivity. Women with atypical hyperplasia were found to have a higher frequency of estrogen receptor-positive BC (91%) compared with women with proliferative disease without atypia (80%) or nonproliferative disease (85%) (P=.02). CONCLUSIONS: A substantial percentage of all BCs develop in women with prior BBD. The majority of BCs after BBD are invasive tumors of ductal type, with a substantial number demonstrating lymph node positivity. Of all the BCs in the current study, 84% were estrogen receptor positive. Prevention therapy should be strongly encouraged in higher-risk women with BBD.

KW - Atypical hyperplasia

KW - Benign breast disease

KW - Breast cancer features

KW - Breast cancer risk

KW - Risk

KW - Tumor characteristics

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