Emobileclinic Researchers’ corner
There is high risk of breast cancer among women with breast lump when combined with family history of breast cancer says a recent study. The presence of lump in the breast is an important risk factor for a later breast cancer, which can develop in either breast says previous studies. There are different subdivision of benign breast disease namely nonproliferative lesions (they remain as they are),proliferative lesions without atypia (they grow in size ) and atypical hyperplasias which increases and with the risk of breast cancer.
According to Dr. Lynn of Divisions of Medical Oncology, Wayne State University, Detroit , identifying types of benign has become simpler with the use mammography and ”having accurate risk estimates for women who receive this diagnosis is imperative,” he said. Several studies had said one or two things about the relationship between benign breast disease and cancer. One of such was ”Dupont and Page who found that women with nonproliferative disease did not have an increased risk of a later breast cancer,” but had 11 times risk when combined with family history . Another study (Surgical Adjuvant Breast and Bowel Project -NSABP) also found that women who received a diagnosis of a “lower category” of benign breast disease have a high risk of breast cancer.
With these conflicting studies, a comprehensive studies and analysis was needed. Thus Lynn C. Hartmann, M.D and his colleague’s study was needed to clarify all previous notions. ”To investigate these questions, we studied 9087 women with benign breast disease for whom we had follow-up data on breast-cancer events. This cohort has been followed for a median of 15 years, and 707 breast cancers have developed, making this, to our knowledge, one of the largest such studies of its kind”, they said.
”The type of benign breast disease identified at biopsy was a major predictor of risk” ,they said. Women with atypical hyperplasia had a relative risk ratio of 4.24 , while women with proliferative disease without atypia had a relative risk of 1.88 , and nonproliferative lesions had a relative risk of 1.27 .
They noted that family history is a major factor which they said ”was an independent risk factor” in women with a ‘strong’ family history of breast cancer as reflected on the groups. They equally noted that ”women with atypia are at significantly increased risk,” with family history . The risk was 4 times high with combination of atypia and family history of breast cancer (27.9% vs 19.8%) which equals to 64 of 336 women developed breast cancer in this group. While the atypia without family history was a bit lower to those with family history at the drop ratio of 2.95.
The study was unique for its ability to show histologic features, the age at biopsy, and the degree of family history as major determinants of risk of breast cancer in women with breast lump. ”We found no increased risk among women with nonproliferative lesions, unless a strong family history was present. No significant interaction between atypia and family history was apparent. The excess risk of cancer in the ipsilateral breast in the first 10 years after the diagnosis of benign breast disease, especially in women with atypia, points to the presence of precursors in some women,” they concluded.
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