Ellen L Nutter1, Julia E Weiss2, Jonathan D Marotti3, Richard J Barth3, M Scottie Eliassen4, Martha E Goodrich2, Curtis L Petersen5, Tracy Onega2,5,6,7. 1. Quantitative Biomedical Science Program, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 2. Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 3. Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 4. Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 5. Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, New Hampshire. 6. Norris Cotton Cancer Center, Lebanon, New Hampshire. 7. Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Abstract
BACKGROUND: A history of proliferative breast disease with atypia (PBDA) may be indicative of an increased risk not just of breast cancer but also of a more aggressive form of breast cancer. METHODS: Multifocal breast cancer (MFBC), defined as 2 or more tumors in the same breast upon a diagnosis of cancer, is associated with a poorer prognosis than unifocal (single-tumor) breast cancer. PBDA, including atypical ductal hyperplasia and atypical lobular hyperplasia, is a known risk factor for breast cancer. Using New Hampshire Mammography Network data collected for 3567 women diagnosed with incident breast cancer from 2004 to 2014, this study assessed the risk of MFBC associated with a previous diagnosis of PBDA. RESULTS: Women with a history of PBDA were found to be twice as likely to be subsequently diagnosed with MFBC as women with no history of benign breast disease (BBD; odds ratio [OR], 2.23; 95% confidence interval [CI], 1.08-4.61). Ductal carcinoma in situ on initial biopsy was associated with a 2-fold increased risk of MFBC in comparison with invasive cancer (OR, 2.13; 95% CI, 1.58-2.88). BBD and proliferative BBD without atypia were not associated with MFBC. CONCLUSIONS: Women with a history of previous PBDA may be at increased risk for MFBC. Women with a history of PBDA may benefit from additional presurgical clinical workup. Cancer 2018;124:1350-7.
BACKGROUND: A history of proliferative breast disease with atypia (PBDA) may be indicative of an increased risk not just of breast cancer but also of a more aggressive form of breast cancer. METHODS: Multifocal breast cancer (MFBC), defined as 2 or more tumors in the same breast upon a diagnosis of cancer, is associated with a poorer prognosis than unifocal (single-tumor) breast cancer. PBDA, including atypical ductal hyperplasia and atypical lobular hyperplasia, is a known risk factor for breast cancer. Using New Hampshire Mammography Network data collected for 3567 women diagnosed with incident breast cancer from 2004 to 2014, this study assessed the risk of MFBC associated with a previous diagnosis of PBDA. RESULTS:Women with a history of PBDA were found to be twice as likely to be subsequently diagnosed with MFBC as women with no history of benign breast disease (BBD; odds ratio [OR], 2.23; 95% confidence interval [CI], 1.08-4.61). Ductal carcinoma in situ on initial biopsy was associated with a 2-fold increased risk of MFBC in comparison with invasive cancer (OR, 2.13; 95% CI, 1.58-2.88). BBD and proliferative BBD without atypia were not associated with MFBC. CONCLUSIONS:Women with a history of previous PBDA may be at increased risk for MFBC. Women with a history of PBDA may benefit from additional presurgical clinical workup. Cancer 2018;124:1350-7.
Authors: Constance D Lehman; Constantine Gatsonis; Christiane K Kuhl; R Edward Hendrick; Etta D Pisano; Lucy Hanna; Sue Peacock; Stanley F Smazal; Daniel D Maki; Thomas B Julian; Elizabeth R DePeri; David A Bluemke; Mitchell D Schnall Journal: N Engl J Med Date: 2007-03-28 Impact factor: 91.245
Authors: Tracy Onega; Julia E Weiss; Diana S M Buist; Anna N A Tosteson; Louise M Henderson; Karla Kerlikowske; Martha E Goodrich; Cristina O'Donoghue; Karen J Wernli; Wendy B DeMartini; Beth A Virnig; Caroline S Bennette; Rebecca A Hubbard Journal: Med Care Date: 2016-07 Impact factor: 2.983
Authors: Tarek M A Abdel-Fatah; Desmond G Powe; Zsolt Hodi; Jorge S Reis-Filho; Andrew H S Lee; Ian O Ellis Journal: Am J Surg Pathol Date: 2008-04 Impact factor: 6.394