Patil Vidya, Ruterbusch Julie J, Chen Wei, Boerner Julie L, Abdulfatah Eman, Alosh Baraa, Pardeshi Visakha, Shaik Asra N, Bandyopadhyay Sudeshna, Ali-Fehmi Rouba, Cote Michele L
Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN, United States.
Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States.
Front Oncol. 2024 May 16;14:1410819. doi: 10.3389/fonc.2024.1410819. eCollection 2024.
The risk of developing subsequent breast cancer is higher in women diagnosed with benign breast disease (BBD) but these studies were primarily performed in non-Hispanic white populations. Still, these estimates have been used to inform breast cancer risk models that are being used clinically across all racial and ethnic groups. Given the high breast cancer mortality rates among African American (AA) women, it is critical to study BBD in this population, to ensure the risk models that include this information perform adequately. This study utilized data from AA women who underwent benign breast biopsies at a hospital served by the University Pathology Group in Detroit, Michigan, from 1998 to 2010. Patients were followed for subsequent breast cancers through the population-based Metropolitan Detroit Cancer Surveillance System (MDCSS). BBD lesion scores were assigned to represent the severity or extent of benign breast lesions, with higher scores indicating a greater number of distinct lesion types. Of 3,461 eligible AA women with BBD in the cohort, 6.88% (n=238) subsequently developed breast cancer. Examined individually, six of the eleven lesions (apocrine metaplasia, ductal hyperplasia, lobular hyperplasia, intraductal papilloma, sclerosing adenosis, columnar alterations and radial scars) were significantly associated with increased risk of breast cancer after adjustment for age and year of biopsy and were further considered in multiple lesion models. For every different type of benign breast lesion, subsequent risk of breast cancer increased by 25% (RR=1.25, 95% CI: 1.10, 1.42) after adjustment for age at biopsy and proliferative versus non-proliferative disease. In summary, this study affirms the increased breast cancer risk in AA women with BBD, particularly in those with multiple lesions. These findings have implications for the management of breast cancer risk in millions of women affected by BBD, a high risk group that could benefit from personalized surveillance and risk reduction strategies.
被诊断患有良性乳腺疾病（BBD）的女性患后续乳腺癌的风险更高，但这些研究主要是在非西班牙裔白人人群中进行的。尽管如此，这些估计值已被用于为目前在所有种族和族裔群体中临床使用的乳腺癌风险模型提供信息。鉴于非裔美国（AA）女性的乳腺癌死亡率很高，在这一人群中研究BBD至关重要，以确保包含此信息的风险模型能够充分发挥作用。本研究利用了1998年至2010年在密歇根州底特律市大学病理集团服务的一家医院接受良性乳腺活检的AA女性的数据。通过基于人群的底特律大都会癌症监测系统（MDCSS）对患者进行后续乳腺癌跟踪。BBD病变评分用于表示良性乳腺病变的严重程度或范围，分数越高表明不同病变类型的数量越多。在该队列中3461名符合条件的患有BBD的AA女性中，6.88%（n = 238）随后患了乳腺癌。单独检查发现，在对活检年龄和年份进行调整后，11种病变中的6种（大汗腺化生、导管增生、小叶增生、导管内乳头状瘤、硬化性腺病、柱状改变和放射状瘢痕）与乳腺癌风险增加显著相关，并在多个病变模型中进一步进行了考虑。对于每一种不同类型的良性乳腺病变，在对活检年龄以及增殖性与非增殖性疾病进行调整后，后续患乳腺癌的风险增加25%（RR = 1.25，95%CI：1.10，1.42）。总之，本研究证实了患有BBD的AA女性患乳腺癌的风险增加，尤其是那些有多种病变的女性。这些发现对数百万受BBD影响的女性的乳腺癌风险管理具有启示意义，这一高危群体可从个性化监测和风险降低策略中受益。
