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Benign Breast Disease May Be Independent Risk Factor for Invasive Breast Cancer

Benign Breast Disease May Be Independent Risk Factor for Invasive Breast Cancer

PITTSBURGH—Women with benign breast disease were 54% more likely to develop
invasive breast cancer than were women without a diagnosis of benign breast
disease, according to an analysis of data from Breast Cancer Prevention Trial (BCPT)
of the National Surgical Adjuvant Breast and Bowel Project (NSABP). Lead
investigator Jiping Wang, MD, a research associate in biostatistics at the
University of Pittsburgh and a statistician for the NSABP, reported that the
risk associated with benign breast disease was higher among women age 50 and
older.

The overall BCPT study population was 13,388 healthy women who were
prospectively followed to determine the effect of tamoxifen treatment on the
development of breast cancer. All breast biopsies undertaken during the trial
were systematically reported, providing a good opportunity to examine the
relationship between benign breast disease and invasive breast cancer, Dr. Wang
said.

Benign Disease Diagnoses

The current study population was 11,307 women who were selected from the
overall BCPT population because they did not have a history of atypical
hyperplasia or in situ cancer. Benign breast disease diagnoses were derived
from pathology reports from participating institutions and consisted of
adenosis, cyst, duct ectasia, fibrocystic disease, fibroadenoma, fibrosis,
hyperplasia, metaplasia, and papilloma. All benign breast disease diagnoses
were made after randomization in the BCPT study and prior to the diagnosis of
invasive breast cancer. The study time period was April 1992 through March
1998.

During the study, 1,301 women received a diagnosis of benign breast disease,
and 29 went on to develop invasive breast cancer. Among the 10,006 women who
did not have a benign breast disease diagnosis, 193 developed breast cancer.
That made the annual rate of invasive breast cancer 8.42/1,000 women with
benign breast disease, compared to 4.47/1,000 for women without benign breast
disease (relative risk: 1.78).

When the researchers analyzed the data according to age, women with benign
breast disease who were age 49 or younger had an annual rate of invasive breast
cancer of 5.85/1,000 vs 4.61/1,000 for women without benign breast disease
(relative risk: 1.24) For women age 50 and older, those with benign breast
disease had an annual rate of invasive breast cancer of 12.18/1,000 vs
4.39/1,000 for those without the benign breast disease diagnosis (relative
risk: 2.58).

Invasive Disease Risk

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