PDF(Pubmed)
Abstract：
The risk of developing subsequent breast cancer is higher in women diagnosed with benign breast disease (BBD) but these studies were primarily performed in non-Hispanic white populations. Still, these estimates have been used to inform breast cancer risk models that are being used clinically across all racial and ethnic groups. Given the high breast cancer mortality rates among African American (AA) women, it is critical to study BBD in this population, to ensure the risk models that include this information perform adequately. This study utilized data from AA women who underwent benign breast biopsies at a hospital served by the University Pathology Group in Detroit, Michigan, from 1998 to 2010. Patients were followed for subsequent breast cancers through the population-based Metropolitan Detroit Cancer Surveillance System (MDCSS). BBD lesion scores were assigned to represent the severity or extent of benign breast lesions, with higher scores indicating a greater number of distinct lesion types. Of 3,461 eligible AA women with BBD in the cohort, 6.88% (n=238) subsequently developed breast cancer. Examined individually, six of the eleven lesions (apocrine metaplasia, ductal hyperplasia, lobular hyperplasia, intraductal papilloma, sclerosing adenosis, columnar alterations and radial scars) were significantly associated with increased risk of breast cancer after adjustment for age and year of biopsy and were further considered in multiple lesion models. For every different type of benign breast lesion, subsequent risk of breast cancer increased by 25% (RR=1.25, 95% CI: 1.10, 1.42) after adjustment for age at biopsy and proliferative versus non-proliferative disease. In summary, this study affirms the increased breast cancer risk in AA women with BBD, particularly in those with multiple lesions. These findings have implications for the management of breast cancer risk in millions of women affected by BBD, a high risk group that could benefit from personalized surveillance and risk reduction strategies.
摘要：
诊断为良性乳腺疾病（BBD）的女性患乳腺癌的风险更高，但这些研究主要在非西班牙裔白人人群中进行。尽管如此，这些估计值已被用于为所有种族和族裔群体临床使用的乳腺癌风险模型提供信息.鉴于非洲裔美国人（AA）女性的高乳腺癌死亡率，在这个人群中研究BBD至关重要，以确保包含此信息的风险模型充分执行。这项研究利用了在底特律大学病理学小组服务的一家医院接受良性乳腺活检的AA女性的数据，密歇根州,从1998年到2010年。通过基于人群的底特律大都会癌症监测系统（MDCSS）对患者进行后续乳腺癌随访。BBD病变评分被指定为代表良性乳腺病变的严重程度或范围。较高的分数表明更多的不同的病变类型。在队列中，有3,461名合格的AA女性患有BBD，6.88%（n=238）随后发展为乳腺癌。单独检查,十一个病变中的六个（大汗腺化生，导管增生,小叶增生,导管内乳头状瘤，硬化性腺病,柱状改变和放射状疤痕）在调整年龄和活检年份后与乳腺癌风险增加显着相关，并在多病变模型中进一步考虑。对于每种不同类型的良性乳腺病变，在校正活检年龄和增殖性与非增殖性疾病后,后续乳腺癌风险增加25%(RR=1.25,95%CI:1.10,1.42).总之,这项研究证实了患BBD的AA女性患乳腺癌的风险增加，尤其是那些有多个病变的患者。这些发现对数百万受BBD影响的女性乳腺癌风险的管理具有重要意义。可从个性化监测和风险降低策略中获益的高危人群.
