PURPOSE: Atypical hyperplasia is a well-recognized risk factor for breast cancer, conveying an approximately four-fold increased risk. Data regarding long-term absolute risk and factors for risk stratification are needed. PATIENTS AND METHODS: Women with atypical hyperplasia in the Mayo Benign Breast Disease Cohort were identified through pathology review. Subsequent breast cancers were identified via medical records and a questionnaire. Relative risks (RRs) were estimated using standardized incidence ratios, comparing the observed number of breast cancers with those expected based on Iowa Surveillance, Epidemiology, and End Results (SEER) data. Age, histologic factors, and family history were evaluated as risk modifiers. Plots of cumulative breast cancer incidence provided estimates of risk over time. RESULTS: With mean follow-up of 13.7 years, 66 breast cancers (19.9%) occurred among 331 women with atypia. RR of breast cancer with atypia was 3.88 (95% CI, 3.00 to 4.94). Marked elevations in risk were seen with multifocal atypia (eg, three or more foci with calcifications [RR, 10.35; 95% CI, 6.13 to 16.4]). RR was higher for younger women (< 45; RR, 6.76; 95% CI, 3.24 to 12.4). Risk was similar for atypical ductal and atypical lobular hyperplasia, and family history added no significant risk. Breast cancer risk remained elevated over 20 years, and the cumulative incidence approached 35% at 30 years. CONCLUSION: Among women with atypical hyperplasia, multiple foci of atypia and the presence of histologic calcifications may indicate "very high risk" status (> 50% risk at 20 years). A positive family history does not further increase risk in women with atypia.
PURPOSE:Atypical hyperplasia is a well-recognized risk factor for breast cancer, conveying an approximately four-fold increased risk. Data regarding long-term absolute risk and factors for risk stratification are needed. PATIENTS AND METHODS: Women with atypical hyperplasia in the Mayo Benign Breast Disease Cohort were identified through pathology review. Subsequent breast cancers were identified via medical records and a questionnaire. Relative risks (RRs) were estimated using standardized incidence ratios, comparing the observed number of breast cancers with those expected based on Iowa Surveillance, Epidemiology, and End Results (SEER) data. Age, histologic factors, and family history were evaluated as risk modifiers. Plots of cumulative breast cancer incidence provided estimates of risk over time. RESULTS: With mean follow-up of 13.7 years, 66 breast cancers (19.9%) occurred among 331 women with atypia. RR of breast cancer with atypia was 3.88 (95% CI, 3.00 to 4.94). Marked elevations in risk were seen with multifocal atypia (eg, three or more foci with calcifications [RR, 10.35; 95% CI, 6.13 to 16.4]). RR was higher for younger women (< 45; RR, 6.76; 95% CI, 3.24 to 12.4). Risk was similar for atypical ductal and atypical lobular hyperplasia, and family history added no significant risk. Breast cancer risk remained elevated over 20 years, and the cumulative incidence approached 35% at 30 years. CONCLUSION: Among women with atypical hyperplasia, multiple foci of atypia and the presence of histologic calcifications may indicate "very high risk" status (> 50% risk at 20 years). A positive family history does not further increase risk in women with atypia.
Authors: Tina J Hieken; Jodi M Carter; John R Hawse; Tanya L Hoskin; Melanie Bois; Marlene Frost; Lynn C Hartmann; Derek C Radisky; Daniel W Visscher; Amy C Degnim Journal: Cancer Prev Res (Phila) Date: 2015-08-14
Authors: Patricia A Carney; Andrea J Cook; Diana L Miglioretti; Stephen A Feig; Erin Aiello Bowles; Berta M Geller; Karla Kerlikowske; Mark Kettler; Tracy Onega; Joann G Elmore Journal: J Clin Epidemiol Date: 2011-10-15 Impact factor: 6.437
Authors: Marta Santisteban; Carol Reynolds; Emily G Barr Fritcher; Marlene H Frost; Robert A Vierkant; Stephanie S Anderson; Amy C Degnim; Daniel W Visscher; V Shane Pankratz; Lynn C Hartmann Journal: Breast Cancer Res Treat Date: 2009-09-23 Impact factor: 4.872
Authors: Geoffrey C Kabat; Joan G Jones; Neal Olson; Abdissa Negassa; Catherine Duggan; Mindy Ginsberg; Rita A Kandel; Andrew G Glass; Thomas E Rohan Journal: Cancer Causes Control Date: 2010-01-19 Impact factor: 2.506
Authors: V Shane Pankratz; Lynn C Hartmann; Amy C Degnim; Robert A Vierkant; Karthik Ghosh; Celine M Vachon; Marlene H Frost; Shaun D Maloney; Carol Reynolds; Judy C Boughey Journal: J Clin Oncol Date: 2008-10-14 Impact factor: 44.544