Breast cancer risk associated with benign breast disease: systematic review and meta-analysis

Abstract

Benign breast disease (BBD) is a broad category of diagnoses reported to convey a variable degree of increased risk of developing breast cancer. A meta-analysis of the existing literature was performed to quantify the risk estimate associated with BBD. Pubmed, Google Scholar, and EMBASE databases were searched in January 2011. English retrospective and prospective observational studies published from 1972 to 2010 evaluating BBD and the risk of breast cancer were included with data acquisition reported from 1930 to 2007. Eligibility was performed independently following a standardized protocol for full-text publication review by a single reviewer and reviewed by a second author. Of the 3,409 articles retrieved from the literature search, 32 studies met the selection criteria. Reported risk estimates, including relative risk, odds ratio, standardized incidence ratios, rate ratio, hazards ratio, and incidence rate ratio, were the primary outcomes extracted. The most commonly reported pathologies were decided prior to extraction and organized into the following categories for analysis of the extracted risk estimate: non-proliferative disease (NPD), proliferative disease without atypia, benign breast disease not otherwise specified (BBD), and atypical hyperplasia not otherwise specified (AHNOS). The mean age at benign breast biopsy was 46.1 years and the mean age of developing breast cancer was 55.9 years. The mean follow-up length was 12.8 years (range 3.3-20.6). The summary risk estimate of developing breast cancer for NPD was 1.17 (N = 8; 95% CI 0.94-1.47). Proliferative disease without atypia was associated with significantly increased risk of future breast cancer, summary relative risk 1.76 (N = 15; 95% CI 1.58-1.95). The summary risk estimate for AHNOS was 3.93 (N = 13; 95% CI 3.24-4.76). This meta-analysis demonstrates that proliferative benign breast disease with or without atypia is associated with a significant increase in risk of developing breast cancer. These data support management strategies for women with benign breast disease such as additional screening methods or chemoprevention.

Association between lifestyle, menstrual/reproductive history, and histological factors and risk of breast cancer in women biopsied for benign breast disease

“…However, there was a very strong, statistically significant positive association between atypical hyperplasia and risk. The latter finding is in agreement with those of previous studies (1,2,13,42,43). Although only a small proportion of women with BBD are diagnosed with atypical hyperplasia, this lesion is potentially clinically relevant as it has been hypothesized that it may be a premalignant lesion, given that it contains some of the features that characterize breast cancers (44,45).…”

“…Similar to previous studies, the current study showed an increased risk of breast cancer among women with epithelial hyperplasia without atypia although the association was not statistically significant (1–3,13,42,43). However, there was a very strong, statistically significant positive association between atypical hyperplasia and risk.…”

The Effect of Deep Oscillation Therapy in Fibrocystic Breast Disease. A Randomized Controlled Clinical Trial

“…Some papers record that it is more frequent between the ages of 25 and 40 and others between 40 and 50, a phase which coincides with sexual maturity and consequently frequent hormonal disorders [1,8,22]. Table 1 shows that of a total of 401 patients, 61.0% were aged between 31 and 40 years and only 17.0% between 41 and 50.…”

Mammographic Density as a Criterion of the Efficiency of Treatment of Benign Breast Disease and Reducing Risk of Breast Cancer

“…Недавно был проведен метаанализ 32 эпидемиологических ре-троспективных и проспективных исследований о свя-зи мастопатии с риском рака МЖ. Средний возраст пациенток в период выявления мастопатии при биоп-сии составил 46,1 года, средний возраст диагноза рака МЖ -55,9, средний срок наблюдения -12,8 года (3,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)6); относительный риск рака МЖ при непро-лиферативных формах мастопатии статистически не-достоверно повышался до 1,17, при пролиферативных формах без атипии -статистически достоверно повы-шался до 1,76, при пролиферативных формах с ати-пией -до 3,93. Авторы делают вывод, что пролифера-тивные формы мастопатии как без атипии, так и с атипией значимо повышают риск рака МЖ [8].…”