TY - JOUR
T1 - Extent of atypical hyperplasia stratifies breast cancer risk in 2 independent cohorts of women
AU - Degnim, Amy C.
AU - Dupont, William D.
AU - Radisky, Derek C.
AU - Vierkant, Robert A.
AU - Frank, Ryan D.
AU - Frost, Marlene H.
AU - Winham, Stacey J.
AU - Sanders, Melinda E.
AU - Smith, Jeffrey R.
AU - Page, David L.
AU - Hoskin, Tanya L.
AU - Vachon, Celine M.
AU - Ghosh, Karthik
AU - Hieken, Tina J.
AU - Denison, Lori A.
AU - Carter, Jodi M.
AU - Hartmann, Lynn C.
AU - Visscher, Daniel W.
N1 - Funding Information:
The work at the Mayo Clinic was funded by the Breast Cancer Specialized Program of Research Excellence (National Cancer Institute (R01 CA187112), (P50 CA116201), Komen (KG 110542-2) and National Cancer Institute (R21 CA186734). The work at Vanderbilt University was funded by the National Institutes of Health (grants R01 CA050468, P50 CA098131, and P30 CA068485). Amy C. Degnim reports grants from the National Institutes of Health and Komen during the conduct of the study. William D. Dupont reports grants from the National Institutes of Health during the conduct of the study and outside the submitted work. Marlene H. Frost reports grants from the National Cancer Institute and the Andersen Foundation during the conduct of the study. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. Daniel Visscher and Derek Radisky reports grants from the National Institutes of Health and the Bankhead-Coley Cancer Research Program during the conduct of this study.
PY - 2016/10
Y1 - 2016/10
N2 - BACKGROUND: Women with atypical hyperplasia (AH) on breast biopsy have a substantially increased risk of breast cancer (BC). Here the BC risk for the extent and subtype of AH is reported for 2 separate cohorts. METHODS: All samples containing AH were included from 2 cohorts of women with benign breast disease (Mayo Clinic and Nashville). Histology review quantified the number of foci of atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH). The BC risk was stratified for the number of AH foci within AH subtypes. RESULTS: The study included 708 Mayo AH subjects and 466 Nashville AH subjects. In the Mayo cohort, an increasing number of foci of AH was associated with a significant increase in the risk of BC both for ADH (relative risks of 2.61, 5.21, and 6.36 for 1, 2, and ≥ 3 foci, respectively; P for linear trend = .006) and for ALH (relative risks of 2.56, 3.50, and 6.79 for 1, 2, and ≥ 3 foci, respectively; P for linear trend = .001). In the Nashville cohort, the relative risks of BC for ADH were 2.70, 5.17, and 15.06 for 1, 2, and ≥ 3 foci, respectively (P for linear trend < .001); for ALH, the relative risks also increased but not significantly (2.61, 3.48, and 4.02, respectively; P = .148). When the Mayo and Nashville samples were combined, the risk increased significantly for 1, 2, and ≥ 3 foci: the relative risks were 2.65, 5.19, and 8.94, respectively, for ADH (P < .001) and 2.58, 3.49, and 4.97, respectively, for ALH (P = .001). CONCLUSIONS: In 2 independent cohort studies of benign breast disease, the extent of atypia stratified the long-term BC risk for ADH and ALH.
AB - BACKGROUND: Women with atypical hyperplasia (AH) on breast biopsy have a substantially increased risk of breast cancer (BC). Here the BC risk for the extent and subtype of AH is reported for 2 separate cohorts. METHODS: All samples containing AH were included from 2 cohorts of women with benign breast disease (Mayo Clinic and Nashville). Histology review quantified the number of foci of atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH). The BC risk was stratified for the number of AH foci within AH subtypes. RESULTS: The study included 708 Mayo AH subjects and 466 Nashville AH subjects. In the Mayo cohort, an increasing number of foci of AH was associated with a significant increase in the risk of BC both for ADH (relative risks of 2.61, 5.21, and 6.36 for 1, 2, and ≥ 3 foci, respectively; P for linear trend = .006) and for ALH (relative risks of 2.56, 3.50, and 6.79 for 1, 2, and ≥ 3 foci, respectively; P for linear trend = .001). In the Nashville cohort, the relative risks of BC for ADH were 2.70, 5.17, and 15.06 for 1, 2, and ≥ 3 foci, respectively (P for linear trend < .001); for ALH, the relative risks also increased but not significantly (2.61, 3.48, and 4.02, respectively; P = .148). When the Mayo and Nashville samples were combined, the risk increased significantly for 1, 2, and ≥ 3 foci: the relative risks were 2.65, 5.19, and 8.94, respectively, for ADH (P < .001) and 2.58, 3.49, and 4.97, respectively, for ALH (P = .001). CONCLUSIONS: In 2 independent cohort studies of benign breast disease, the extent of atypia stratified the long-term BC risk for ADH and ALH.
KW - Atypical ductal hyperplasia
KW - Atypical hyperplasia
KW - Atypical lobular hyperplasia
KW - Breast cancer
KW - Risk
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U2 - 10.1002/cncr.30153
DO - 10.1002/cncr.30153
M3 - Article
C2 - 27352219
AN - SCOPUS:84978438131
VL - 122
SP - 2971
EP - 2978
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 19
ER -