Chronic mastopathy and breast cancer:A Follow-Up Study

Abstract

Over an average period of seven years 2,900 cases of benign breast lesions diagnosed by biopsy between 1948 and 1973 in the Department of Pathology, Kaiser Foundation Hospital, Oakland, were followed for breast cancer development. When classified according to traditional diagnostic categories, the cancer incidence per 1,000 person-years varies between 2.7 and 7.9 and appears to be elevated in comparison to expectations obtained from the Third National Cancer Survey, San Francisco Bay Area. Two thousand four hundred biopsies were also scored by the Black-Chabon method. There is an upward trend in the breast cancer incidence as the atypia score rises, a finding which confirms conclusions from a retrospective case-control study by Black et al.

The Epidemiology of Benign Breast Disease

“…An example of the importance of such adjustment is demonstrated by fibroadenoma. Two studies (26,32) have shown an association between fibroadenoma and increased breast cancer risk, whereas two other studies (21,29) have not. Hutchinson et al (28) reported an elevated risk for women whose fibroadenoma was accompanied by fibrocystic disease, but not for women who had fibroadenoma alone.…”

“…Table 2 summarizes the results of studies that have addressed this issue. With two exceptions (18,19) these were prospective studies that followed women with biopsy-defined BBD over time and compared the observed number of breast cancers that developed with the expected number based on the experience of the general population (2,4,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

“…Two studies (18,26) have shown breast cancer risk gradients that are positively associated with atypia score; two other studies (27,28) have not found the increased breast cancer risk associated with ductal hyperplasia to be augmented by the presence of atypia. However, in one of the latter studies (27), atypical lobular hyperplasia was associated with the highest risk of cancer development of all the hyperplastic and nonhyperplastic types of benign disease studied.…”

“…However, a positive gradient was found between risk of disease and degree of atypia, and, among women who had used the pill four or more years, this association was statistically significant. The findings suggested that the subset of women with marked atypia-which two studies (18,26) have associated with greatest risk of subsequent breast cancer-was a group for whom the protective relation between oral contraceptive use and benign disease did not obtain. More extensive recent data from that group, however, show no significant differences in contraceptive use by degree of atypia (74).…”

A Systematic Study On Fibroadenoma Of The Breast

“…Though none of our cases presented with recurrence or carcinoma within fibroadenoma specimen. Breast cancer risk for fibroadenoma has been estimated at 3.1 annual incidence per 1000, person-year rate, and the relative cancer risk estimated at 7.0 [26][27] . A more recent study designed to delineate the possible correlation between the histologic features of the fibroadenoma and the risk for subsequent breast cancer used the term "complex fibroadenoma."…”