Pseudoangiomatous stromal hyperplasia and breast cancer risk

Amy C Degnim, Marlene H. Frost, Derek C Radisky, Stephanie S. Anderson, Robert A. Vierkant, Judy C Boughey, V. Shane Pankratz, Karthik Ghosh, Lynn C. Hartmann, Daniel W Visscher

Research output: Contribution to journalArticle

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Abstract

Background: Pseudoangiomatous stromal hyperplasia (PASH) is a benign localized fibrotic lesion in which clusters of spindle cells form cleftlike spaces, resembling ectatic vessels. Its relationship to breast cancer risk has not been characterized. Materials and Methods: Histological presence of PASH was evaluated by review of archival slides in a single institution cohort of women who underwent benign excisional breast biopsy from 1967 to 1991. Relative risks for subsequent breast cancer were estimated using standardized incidence ratios (SIR), comparing the observed number of cancers with those expected based on Iowa SEER data (mean follow-up 18.5 years). Results: PASH was identified in 579 of 9065 biopsies (6.4%). Women with PASH were younger, more likely to have a palpable mass as indication for biopsy, and had less lobular involution compared with those without PASH (all P < 0.001), while they did not differ by family history of breast cancer or degree of epithelial proliferation. Breast cancers occurred in 34 women with PASH (5.9%) and 789 without (8.8%). Women with PASH had lower risk of breast cancer (SIR 1.03, 95% confidence interval [95% CI] 0.71-1.44) than those without PASH (SIR 1.54, 95% CI 1.43-1.65), P = 0.01. Lower levels of breast cancer risk for the PASH group persisted in analyses stratified by age, family history, epithelial proliferation, and involution. The cancers in the PASH group occurred predominantly in the ipsilateral breast more than 5 years after biopsy. Conclusions: Despite clinical concern generated by palpable density often associated with PASH, this relatively uncommon histological finding does not connote increased risk of subsequent breast cancer.

Original languageEnglish (US)
Pages (from-to)3269-3277
Number of pages9
JournalAnnals of Surgical Oncology
Volume17
Issue number12
DOIs
StatePublished - Dec 2010

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Breast Neoplasms
Biopsy
Incidence
Breast
Pseudoangiomatous stromal hyperplasia
Confidence Intervals
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Surgery

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Pseudoangiomatous stromal hyperplasia and breast cancer risk. / Degnim, Amy C; Frost, Marlene H.; Radisky, Derek C; Anderson, Stephanie S.; Vierkant, Robert A.; Boughey, Judy C; Shane Pankratz, V.; Ghosh, Karthik; Hartmann, Lynn C.; Visscher, Daniel W.

In: Annals of Surgical Oncology, Vol. 17, No. 12, 12.2010, p. 3269-3277.

Research output: Contribution to journalArticle

Degnim, Amy C ; Frost, Marlene H. ; Radisky, Derek C ; Anderson, Stephanie S. ; Vierkant, Robert A. ; Boughey, Judy C ; Shane Pankratz, V. ; Ghosh, Karthik ; Hartmann, Lynn C. ; Visscher, Daniel W. / Pseudoangiomatous stromal hyperplasia and breast cancer risk. In: Annals of Surgical Oncology. 2010 ; Vol. 17, No. 12. pp. 3269-3277.
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title = "Pseudoangiomatous stromal hyperplasia and breast cancer risk",
abstract = "Background: Pseudoangiomatous stromal hyperplasia (PASH) is a benign localized fibrotic lesion in which clusters of spindle cells form cleftlike spaces, resembling ectatic vessels. Its relationship to breast cancer risk has not been characterized. Materials and Methods: Histological presence of PASH was evaluated by review of archival slides in a single institution cohort of women who underwent benign excisional breast biopsy from 1967 to 1991. Relative risks for subsequent breast cancer were estimated using standardized incidence ratios (SIR), comparing the observed number of cancers with those expected based on Iowa SEER data (mean follow-up 18.5 years). Results: PASH was identified in 579 of 9065 biopsies (6.4{\%}). Women with PASH were younger, more likely to have a palpable mass as indication for biopsy, and had less lobular involution compared with those without PASH (all P < 0.001), while they did not differ by family history of breast cancer or degree of epithelial proliferation. Breast cancers occurred in 34 women with PASH (5.9{\%}) and 789 without (8.8{\%}). Women with PASH had lower risk of breast cancer (SIR 1.03, 95{\%} confidence interval [95{\%} CI] 0.71-1.44) than those without PASH (SIR 1.54, 95{\%} CI 1.43-1.65), P = 0.01. Lower levels of breast cancer risk for the PASH group persisted in analyses stratified by age, family history, epithelial proliferation, and involution. The cancers in the PASH group occurred predominantly in the ipsilateral breast more than 5 years after biopsy. Conclusions: Despite clinical concern generated by palpable density often associated with PASH, this relatively uncommon histological finding does not connote increased risk of subsequent breast cancer.",
author = "Degnim, {Amy C} and Frost, {Marlene H.} and Radisky, {Derek C} and Anderson, {Stephanie S.} and Vierkant, {Robert A.} and Boughey, {Judy C} and {Shane Pankratz}, V. and Karthik Ghosh and Hartmann, {Lynn C.} and Visscher, {Daniel W}",
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TY - JOUR

T1 - Pseudoangiomatous stromal hyperplasia and breast cancer risk

AU - Degnim, Amy C

AU - Frost, Marlene H.

AU - Radisky, Derek C

AU - Anderson, Stephanie S.

AU - Vierkant, Robert A.

AU - Boughey, Judy C

AU - Shane Pankratz, V.

AU - Ghosh, Karthik

AU - Hartmann, Lynn C.

AU - Visscher, Daniel W

PY - 2010/12

Y1 - 2010/12

N2 - Background: Pseudoangiomatous stromal hyperplasia (PASH) is a benign localized fibrotic lesion in which clusters of spindle cells form cleftlike spaces, resembling ectatic vessels. Its relationship to breast cancer risk has not been characterized. Materials and Methods: Histological presence of PASH was evaluated by review of archival slides in a single institution cohort of women who underwent benign excisional breast biopsy from 1967 to 1991. Relative risks for subsequent breast cancer were estimated using standardized incidence ratios (SIR), comparing the observed number of cancers with those expected based on Iowa SEER data (mean follow-up 18.5 years). Results: PASH was identified in 579 of 9065 biopsies (6.4%). Women with PASH were younger, more likely to have a palpable mass as indication for biopsy, and had less lobular involution compared with those without PASH (all P < 0.001), while they did not differ by family history of breast cancer or degree of epithelial proliferation. Breast cancers occurred in 34 women with PASH (5.9%) and 789 without (8.8%). Women with PASH had lower risk of breast cancer (SIR 1.03, 95% confidence interval [95% CI] 0.71-1.44) than those without PASH (SIR 1.54, 95% CI 1.43-1.65), P = 0.01. Lower levels of breast cancer risk for the PASH group persisted in analyses stratified by age, family history, epithelial proliferation, and involution. The cancers in the PASH group occurred predominantly in the ipsilateral breast more than 5 years after biopsy. Conclusions: Despite clinical concern generated by palpable density often associated with PASH, this relatively uncommon histological finding does not connote increased risk of subsequent breast cancer.

AB - Background: Pseudoangiomatous stromal hyperplasia (PASH) is a benign localized fibrotic lesion in which clusters of spindle cells form cleftlike spaces, resembling ectatic vessels. Its relationship to breast cancer risk has not been characterized. Materials and Methods: Histological presence of PASH was evaluated by review of archival slides in a single institution cohort of women who underwent benign excisional breast biopsy from 1967 to 1991. Relative risks for subsequent breast cancer were estimated using standardized incidence ratios (SIR), comparing the observed number of cancers with those expected based on Iowa SEER data (mean follow-up 18.5 years). Results: PASH was identified in 579 of 9065 biopsies (6.4%). Women with PASH were younger, more likely to have a palpable mass as indication for biopsy, and had less lobular involution compared with those without PASH (all P < 0.001), while they did not differ by family history of breast cancer or degree of epithelial proliferation. Breast cancers occurred in 34 women with PASH (5.9%) and 789 without (8.8%). Women with PASH had lower risk of breast cancer (SIR 1.03, 95% confidence interval [95% CI] 0.71-1.44) than those without PASH (SIR 1.54, 95% CI 1.43-1.65), P = 0.01. Lower levels of breast cancer risk for the PASH group persisted in analyses stratified by age, family history, epithelial proliferation, and involution. The cancers in the PASH group occurred predominantly in the ipsilateral breast more than 5 years after biopsy. Conclusions: Despite clinical concern generated by palpable density often associated with PASH, this relatively uncommon histological finding does not connote increased risk of subsequent breast cancer.

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U2 - 10.1245/s10434-010-1170-5

DO - 10.1245/s10434-010-1170-5

M3 - Article

VL - 17

SP - 3269

EP - 3277

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 12

ER -