Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease: a nested case–control study

Jonine D. Figueroa, Ruth M. Pfeiffer, Louise A. Brinton, Maya M. Palakal, Amy C Degnim, Derek C Radisky, Lynn C. Hartmann, Marlene H. Frost, Melody L. Stallings Mann, Daphne Papathomas, Gretchen L. Gierach, Stephen M. Hewitt, Maire A. Duggan, Daniel W Visscher, Mark E. Sherman

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Lesser degrees of terminal duct-lobular unit (TDLU) involution predict higher breast cancer risk; however, standardized measures to quantitate levels of TDLU involution have only recently been developed. We assessed whether three standardized measures of TDLU involution, with high intra/inter pathologist reproducibility in normal breast tissue, predict subsequent breast cancer risk among women in the Mayo benign breast disease (BBD) cohort. We performed a masked evaluation of biopsies from 99 women with BBD who subsequently developed breast cancer (cases) after a median of 16.9 years and 145 age-matched controls. We assessed three metrics inversely related to TDLU involution: TDLU count/mm2, median TDLU span (microns, which approximates acini content), and median category of acini counts/TDLU (0–10; 11–20; 21–30; 31–50; >50). Associations with subsequent breast cancer risk for quartiles (or categories of acini counts) of each of these measures were assessed with multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 % confidence intervals (CI). In multivariable models, women in the highest quartile compared to the lowest quartiles of TDLU counts and TDLU span measures were significantly associated with subsequent breast cancer diagnoses; TDLU counts quartile4 versus quartile1, OR = 2.44, 95 %CI 0.96–6.19, p-trend = 0.02; and TDLU spans, quartile4 versus quartile1, OR = 2.83, 95 %CI = 1.13–7.06, p-trend = 0.03. Significant associations with categorical measures of acini counts/TDLU were also observed: compared to women with median category of <10 acini/TDLU, women with >25 acini counts/TDLU were at significantly higher risk, OR = 3.40, 95 %CI 1.03–11.17, p-trend = 0.032. Women with TDLU spans and TDLU count measures above the median were at further increased risk, OR = 3.75 (95 %CI 1.40–10.00, p-trend = 0.008), compared with women below the median for both of these metrics. Similar results were observed for combinatorial metrics of TDLU acini counts/TDLU, and TDLU count. Standardized quantitative measures of TDLU counts and acini counts approximated by TDLU span measures or visually assessed in categories are independently associated with breast cancer risk. Visual assessment of TDLU numbers and acini content, which are highly reproducible between pathologists, could help identify women at high risk for subsequent breast cancer among the million women diagnosed annually with BBD in the US.

Original languageEnglish (US)
Pages (from-to)163-172
Number of pages10
JournalBreast Cancer Research and Treatment
Volume159
Issue number1
DOIs
StatePublished - Aug 1 2016

Fingerprint

Breast Diseases
Breast Neoplasms
Odds Ratio
Confidence Intervals
Breast
Logistic Models
Biopsy

Keywords

  • Breast cancer risk
  • Lobular involution

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease : a nested case–control study. / Figueroa, Jonine D.; Pfeiffer, Ruth M.; Brinton, Louise A.; Palakal, Maya M.; Degnim, Amy C; Radisky, Derek C; Hartmann, Lynn C.; Frost, Marlene H.; Stallings Mann, Melody L.; Papathomas, Daphne; Gierach, Gretchen L.; Hewitt, Stephen M.; Duggan, Maire A.; Visscher, Daniel W; Sherman, Mark E.

In: Breast Cancer Research and Treatment, Vol. 159, No. 1, 01.08.2016, p. 163-172.

Research output: Contribution to journalArticle

Figueroa, JD, Pfeiffer, RM, Brinton, LA, Palakal, MM, Degnim, AC, Radisky, DC, Hartmann, LC, Frost, MH, Stallings Mann, ML, Papathomas, D, Gierach, GL, Hewitt, SM, Duggan, MA, Visscher, DW & Sherman, ME 2016, 'Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease: a nested case–control study', Breast Cancer Research and Treatment, vol. 159, no. 1, pp. 163-172. https://doi.org/10.1007/s10549-016-3908-7
Figueroa, Jonine D. ; Pfeiffer, Ruth M. ; Brinton, Louise A. ; Palakal, Maya M. ; Degnim, Amy C ; Radisky, Derek C ; Hartmann, Lynn C. ; Frost, Marlene H. ; Stallings Mann, Melody L. ; Papathomas, Daphne ; Gierach, Gretchen L. ; Hewitt, Stephen M. ; Duggan, Maire A. ; Visscher, Daniel W ; Sherman, Mark E. / Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease : a nested case–control study. In: Breast Cancer Research and Treatment. 2016 ; Vol. 159, No. 1. pp. 163-172.
@article{e5de5616e7ae44f9b174059cbaa8d484,
title = "Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease: a nested case–control study",
abstract = "Lesser degrees of terminal duct-lobular unit (TDLU) involution predict higher breast cancer risk; however, standardized measures to quantitate levels of TDLU involution have only recently been developed. We assessed whether three standardized measures of TDLU involution, with high intra/inter pathologist reproducibility in normal breast tissue, predict subsequent breast cancer risk among women in the Mayo benign breast disease (BBD) cohort. We performed a masked evaluation of biopsies from 99 women with BBD who subsequently developed breast cancer (cases) after a median of 16.9 years and 145 age-matched controls. We assessed three metrics inversely related to TDLU involution: TDLU count/mm2, median TDLU span (microns, which approximates acini content), and median category of acini counts/TDLU (0–10; 11–20; 21–30; 31–50; >50). Associations with subsequent breast cancer risk for quartiles (or categories of acini counts) of each of these measures were assessed with multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 {\%} confidence intervals (CI). In multivariable models, women in the highest quartile compared to the lowest quartiles of TDLU counts and TDLU span measures were significantly associated with subsequent breast cancer diagnoses; TDLU counts quartile4 versus quartile1, OR = 2.44, 95 {\%}CI 0.96–6.19, p-trend = 0.02; and TDLU spans, quartile4 versus quartile1, OR = 2.83, 95 {\%}CI = 1.13–7.06, p-trend = 0.03. Significant associations with categorical measures of acini counts/TDLU were also observed: compared to women with median category of <10 acini/TDLU, women with >25 acini counts/TDLU were at significantly higher risk, OR = 3.40, 95 {\%}CI 1.03–11.17, p-trend = 0.032. Women with TDLU spans and TDLU count measures above the median were at further increased risk, OR = 3.75 (95 {\%}CI 1.40–10.00, p-trend = 0.008), compared with women below the median for both of these metrics. Similar results were observed for combinatorial metrics of TDLU acini counts/TDLU, and TDLU count. Standardized quantitative measures of TDLU counts and acini counts approximated by TDLU span measures or visually assessed in categories are independently associated with breast cancer risk. Visual assessment of TDLU numbers and acini content, which are highly reproducible between pathologists, could help identify women at high risk for subsequent breast cancer among the million women diagnosed annually with BBD in the US.",
keywords = "Breast cancer risk, Lobular involution",
author = "Figueroa, {Jonine D.} and Pfeiffer, {Ruth M.} and Brinton, {Louise A.} and Palakal, {Maya M.} and Degnim, {Amy C} and Radisky, {Derek C} and Hartmann, {Lynn C.} and Frost, {Marlene H.} and {Stallings Mann}, {Melody L.} and Daphne Papathomas and Gierach, {Gretchen L.} and Hewitt, {Stephen M.} and Duggan, {Maire A.} and Visscher, {Daniel W} and Sherman, {Mark E.}",
year = "2016",
month = "8",
day = "1",
doi = "10.1007/s10549-016-3908-7",
language = "English (US)",
volume = "159",
pages = "163--172",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease

T2 - a nested case–control study

AU - Figueroa, Jonine D.

AU - Pfeiffer, Ruth M.

AU - Brinton, Louise A.

AU - Palakal, Maya M.

AU - Degnim, Amy C

AU - Radisky, Derek C

AU - Hartmann, Lynn C.

AU - Frost, Marlene H.

AU - Stallings Mann, Melody L.

AU - Papathomas, Daphne

AU - Gierach, Gretchen L.

AU - Hewitt, Stephen M.

AU - Duggan, Maire A.

AU - Visscher, Daniel W

AU - Sherman, Mark E.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Lesser degrees of terminal duct-lobular unit (TDLU) involution predict higher breast cancer risk; however, standardized measures to quantitate levels of TDLU involution have only recently been developed. We assessed whether three standardized measures of TDLU involution, with high intra/inter pathologist reproducibility in normal breast tissue, predict subsequent breast cancer risk among women in the Mayo benign breast disease (BBD) cohort. We performed a masked evaluation of biopsies from 99 women with BBD who subsequently developed breast cancer (cases) after a median of 16.9 years and 145 age-matched controls. We assessed three metrics inversely related to TDLU involution: TDLU count/mm2, median TDLU span (microns, which approximates acini content), and median category of acini counts/TDLU (0–10; 11–20; 21–30; 31–50; >50). Associations with subsequent breast cancer risk for quartiles (or categories of acini counts) of each of these measures were assessed with multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 % confidence intervals (CI). In multivariable models, women in the highest quartile compared to the lowest quartiles of TDLU counts and TDLU span measures were significantly associated with subsequent breast cancer diagnoses; TDLU counts quartile4 versus quartile1, OR = 2.44, 95 %CI 0.96–6.19, p-trend = 0.02; and TDLU spans, quartile4 versus quartile1, OR = 2.83, 95 %CI = 1.13–7.06, p-trend = 0.03. Significant associations with categorical measures of acini counts/TDLU were also observed: compared to women with median category of <10 acini/TDLU, women with >25 acini counts/TDLU were at significantly higher risk, OR = 3.40, 95 %CI 1.03–11.17, p-trend = 0.032. Women with TDLU spans and TDLU count measures above the median were at further increased risk, OR = 3.75 (95 %CI 1.40–10.00, p-trend = 0.008), compared with women below the median for both of these metrics. Similar results were observed for combinatorial metrics of TDLU acini counts/TDLU, and TDLU count. Standardized quantitative measures of TDLU counts and acini counts approximated by TDLU span measures or visually assessed in categories are independently associated with breast cancer risk. Visual assessment of TDLU numbers and acini content, which are highly reproducible between pathologists, could help identify women at high risk for subsequent breast cancer among the million women diagnosed annually with BBD in the US.

AB - Lesser degrees of terminal duct-lobular unit (TDLU) involution predict higher breast cancer risk; however, standardized measures to quantitate levels of TDLU involution have only recently been developed. We assessed whether three standardized measures of TDLU involution, with high intra/inter pathologist reproducibility in normal breast tissue, predict subsequent breast cancer risk among women in the Mayo benign breast disease (BBD) cohort. We performed a masked evaluation of biopsies from 99 women with BBD who subsequently developed breast cancer (cases) after a median of 16.9 years and 145 age-matched controls. We assessed three metrics inversely related to TDLU involution: TDLU count/mm2, median TDLU span (microns, which approximates acini content), and median category of acini counts/TDLU (0–10; 11–20; 21–30; 31–50; >50). Associations with subsequent breast cancer risk for quartiles (or categories of acini counts) of each of these measures were assessed with multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 % confidence intervals (CI). In multivariable models, women in the highest quartile compared to the lowest quartiles of TDLU counts and TDLU span measures were significantly associated with subsequent breast cancer diagnoses; TDLU counts quartile4 versus quartile1, OR = 2.44, 95 %CI 0.96–6.19, p-trend = 0.02; and TDLU spans, quartile4 versus quartile1, OR = 2.83, 95 %CI = 1.13–7.06, p-trend = 0.03. Significant associations with categorical measures of acini counts/TDLU were also observed: compared to women with median category of <10 acini/TDLU, women with >25 acini counts/TDLU were at significantly higher risk, OR = 3.40, 95 %CI 1.03–11.17, p-trend = 0.032. Women with TDLU spans and TDLU count measures above the median were at further increased risk, OR = 3.75 (95 %CI 1.40–10.00, p-trend = 0.008), compared with women below the median for both of these metrics. Similar results were observed for combinatorial metrics of TDLU acini counts/TDLU, and TDLU count. Standardized quantitative measures of TDLU counts and acini counts approximated by TDLU span measures or visually assessed in categories are independently associated with breast cancer risk. Visual assessment of TDLU numbers and acini content, which are highly reproducible between pathologists, could help identify women at high risk for subsequent breast cancer among the million women diagnosed annually with BBD in the US.

KW - Breast cancer risk

KW - Lobular involution

UR - http://www.scopus.com/inward/record.url?scp=84982839188&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84982839188&partnerID=8YFLogxK

U2 - 10.1007/s10549-016-3908-7

DO - 10.1007/s10549-016-3908-7

M3 - Article

C2 - 27488681

AN - SCOPUS:84982839188

VL - 159

SP - 163

EP - 172

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 1

ER -