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Multicenter Study
. 2020 Dec:54:343-348.
doi: 10.1016/j.breast.2020.09.005. Epub 2020 Oct 3.

Differences in breast cancer risk after benign breast disease by type of screening diagnosis

Javier Louro  1 , Marta Román  2 , Margarita Posso  2 , Laura Comerma  3 , Carmen Vidal  4 , Francina Saladié  5 , Rodrigo Alcantara  6 , Mar Sanchez  7 , M Jesús Quintana  8 , Javier Del Riego  9 , Joana Ferrer  10 , Lupe Peñalva  11 , Xavier Bargalló  12 , Miguel Prieto  13 , María Sala  2 , Xavier Castells  14
Affiliations
Multicenter Study

Differences in breast cancer risk after benign breast disease by type of screening diagnosis

Javier Louro et al. Breast. 2020 Dec.

Abstract

Introduction: We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens.

Materials and methods: We conducted a retrospective cohort study with data from 629,087 women participating in a long-standing population-based breast cancer screening program in Spain. Each benign breast disease was classified as non-proliferative, proliferative without atypia, or proliferative with atypia, and whether it was diagnosed in a prevalent or incident screen. We used partly conditional Cox hazard regression to estimate the adjusted hazard ratios of the risk of breast cancer.

Results: Compared with women without benign breast disease, the risk of breast cancer was significantly higher (p-value = 0.005) in women with benign breast disease diagnosed in an incident screen (aHR, 2.67; 95%CI: 2.24-3.19) than in those with benign breast disease diagnosed in a prevalent screen (aHR, 1.87; 95%CI: 1.57-2.24). The highest risk was found in women with a proliferative benign breast disease with atypia (aHR, 4.35; 95%CI: 2.09-9.08, and 3.35; 95%CI: 1.51-7.40 for those diagnosed at incident and prevalent screens, respectively), while the lowest was found in women with non-proliferative benign breast disease (aHR, 2.39; 95%CI: 1.95-2.93, and 1.63; 95%CI: 1.32-2.02 for those diagnosed at incident and prevalent screens, respectively).

Conclusion: Our study showed that the risk of breast cancer conferred by a benign breast disease differed according to type of screen (prevalent or incident). To our knowledge, this is the first study to analyse the impact of the screening type on benign breast disease prognosis.

Keywords: Benign breast disease; Breast neoplasms; Early cancer detection; Risk factors.

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Conflict of interest statement

Declaration of competing interest None declared.

Figures

Fig. 1
Fig. 1
Adjusted hazard ratios (aHR) of breast cancer incidence in women with benign breast disease compared with women with negative screening tests.
Fig. 2
Fig. 2
Adjusted hazard ratios (aHR) of breast cancer incidence in women with benign breast disease compared with women with negative screening tests testing the combined effect of type of benign breast disease, and round at benign breast disease diagnosis.
Fig. 3
Fig. 3
Adjusted survival curves for breast cancer incidence based on Cox proportional hazards model for women with benign breast disease vs women with negative screening tests. Fig. 3 a. Solid line represents negative screening test group; dashed line represents benign breast disease diagnosed at prevalent round, dotted line benign breast disease diagnosed in incident round. Fig. 3 b. Solid line represents negative screening test group; dashed line represents nonproliferative benign breast disease, dashdotted line represent proliferative benign breast disease without atypia, dotted line represents proliferative benign breast disease with atypia.
Fig. 4
Fig. 4
Adjusted survival curves for breast cancer incidence based on Cox proportional hazards model for women with benign breast disease vs women with negative screening tests.
See this image and copyright information in PMC

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