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. 2015 Jan;149(1):237-44.
doi: 10.1007/s10549-014-3208-z. Epub 2014 Dec 13.

Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program

Xavier Castells  1 , Laia Domingo, Josep María Corominas, Isabel Torá-Rocamora, María Jesús Quintana, Marisa Baré, Carmen Vidal, Carmen Natal, Mar Sánchez, Francina Saladié, Joana Ferrer, Mar Vernet, Sonia Servitja, Ana Rodríguez-Arana, Marta Roman, Josep Alfons Espinàs, María Sala
Affiliations

Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program

Xavier Castells et al. Breast Cancer Res Treat. 2015 Jan.

Abstract

Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

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Figures

Fig. 1
Fig. 1
Age-adjusted risk of breast cancer after a diagnosis of a nonproliferative and a proliferative lesion (with and without atypia) by family history of breast cancer* *Information on family history of breast cancer was available in 413,873 out of 545,171 women
Fig. 2
Fig. 2
A Time distribution (years) of progression from benign breast disease to breast cancer. B Time distribution (years) from first screen to breast cancer in women without benign breast disease
See this image and copyright information in PMC

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