Changes in Histology and Breast Cancer Risk
More than a million women with benign breast biopsies are known to be at elevated risk for breast cancer each year in the United States. According to a study of more than 1,400 women with serial benign breast biopsies, this risk increased over time for women with progressive epithelial proliferation and decreased in women whose biopsies showed less proliferation, as reported by Daniel W. Visscher, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues in the Journal of the National Cancer Institute.
The study involved 1,414 women in the Mayo Clinic Benign Breast Disease Cohort (N=13,466). The investigators found that changes in the histologic category between initial and subsequent biopsies had a significant effect on the risk for breast cancer in the study population.
Women with nonproliferative initial findings and subsequent proliferative findings had an increased risk for breast cancer, compared with no change. In women with proliferative disease without atypia at initial biopsy, risk decreased if later biopsy regressed to nonproliferative and increased if later biopsy showed progression to atypical hyperplasia. Overall, 140 women (9.9%) developed breast cancer.
“These findings have important implications for optimization of clinical management for the approximately 100,000 women per year in the United States who have multiple, metachronous benign biopsies,” the researchers concluded.