Page D L, Dupont W D, Rogers L W
Cancer Detect Prev. 1986;9(5-6):441-8.
Three thousand three hundred three women were followed an average of 17 years following benign breast biopsy. These women comprise 84.4% of those originally targeted for follow-up. Risk of invasive breast cancer development was analyzed in relation to the hyperplasia classification scheme of Wellings et al (JNCI 1975; 55:231-73) that is based on terminal ductal-lobular units (ALA). Cancer risk was also assessed with respect to family history of breast cancer in first-degree relatives (FHBC), as well as atypical features of hyperplasia recognized by resemblance to carcinoma in situ of ductal type (ADH). There was a trend of increasing cancer risk with increasing degree of ALA lesion, reaching 1.9 with ALA-IV lesions having both qualitative and quantitative features of advanced atypical hyperplasia. When ADH lesions are removed from the analysis, any predictive power of ALA lesions is lost. ADH recognizes histologic lesions with a four- to fivefold increased risk of breast cancer. FHBC interacts with any hyperplastic lesion so as to approximately double the cancer risk.
3303名女性在接受良性乳腺活检后平均随访了17年。这些女性占最初计划随访人数的84.4%。根据Wellings等人（《美国国家癌症研究所杂志》1975年；55:231 - 73）基于终末导管小叶单位（ALA）的增生分类方案，分析了浸润性乳腺癌发生的风险。还评估了一级亲属患乳腺癌家族史（FHBC）以及通过与导管原位癌相似性识别的增生非典型特征（ADH）对癌症风险的影响。随着ALA病变程度的增加，癌症风险呈上升趋势，具有高级别非典型增生定性和定量特征的ALA-IV病变的癌症风险达到1.9。当从分析中去除ADH病变时，ALA病变的任何预测能力都丧失了。ADH识别出乳腺癌风险增加四到五倍的组织学病变。FHBC与任何增生性病变相互作用，使癌症风险大约增加一倍。
