与增殖性乳腺疾病和非典型增生相关的乳腺癌风险。

Breast cancer risk associated with proliferative breast disease and atypical hyperplasia.

作者信息

Dupont W D, Parl F F, Hartmann W H, Brinton L A, Winfield A C, Worrell J A, Schuyler P A, Plummer W D

机构信息

Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2637.

出版信息

Cancer. 1993 Feb 15;71(4):1258-65. doi: 10.1002/1097-0142(19930215)71:4<1258::aid-cncr2820710415>3.0.co;2-i.

DOI:10.1002/1097-0142(19930215)71:4<1258::aid-cncr2820710415>3.0.co;2-i

PMID:8435803

Abstract

BACKGROUND

Women with proliferative breast disease (PD) have been observed to have an increased risk of breast cancer. The authors evaluated the effect of PD on breast cancer risk in a case-control study among participants of the Breast Cancer Detection Demonstration Project (BCDDP).

METHODS

More than 280,000 women were screened in the BCDDP at 29 centers. Study subjects were selected from BCDDP participants who underwent biopsy that revealed benign breast tissue. There were five BCDDP centers for which histologic slides were available on more than 85% of the benign biopsy specimens. Case patients for this study were the 95 women from these five centers who had breast cancer develop during follow-up. Two matched control patients who did not have breast cancer develop were selected for each case. The biopsy slides were reviewed by two pathologists who were blinded with regard to cancer outcome.

RESULTS

Women with atypical hyperplasia (AH) had 4.3 times the breast cancer risk of women without PD (95% confidence interval [CI], 1.7-11). In women with PD lacking AH, the relative risk was 1.3 (95% CI, 0.77-2.2). A family history of breast cancer (FH) increased breast cancer risk 2.4 times (95% CI, 1.4-4.3). The joint occurrence of FH and AH had a strong synergistic effect on breast cancer risk.

CONCLUSIONS

AH is a reliable marker of increased breast cancer risk among women undergoing breast biopsy.

摘要

背景

观察发现，患有增生性乳腺病（PD）的女性患乳腺癌的风险增加。作者在乳腺癌检测示范项目（BCDDP）的参与者中进行了一项病例对照研究，评估了PD对乳腺癌风险的影响。

方法

在29个中心对超过280,000名女性进行了BCDDP筛查。研究对象选自接受活检显示为良性乳腺组织的BCDDP参与者。有五个BCDDP中心，其超过85%的良性活检标本有组织学切片。本研究的病例患者是来自这五个中心的95名在随访期间患乳腺癌的女性。为每个病例选择两名未患乳腺癌的匹配对照患者。活检切片由两名对癌症结果不知情的病理学家进行复查。

结果

非典型增生（AH）女性患乳腺癌的风险是无PD女性的4.3倍（95%置信区间[CI]，1.7 - 11）。在无AH的PD女性中，相对风险为1.3（95% CI，0.77 - 2.2）。乳腺癌家族史（FH）使乳腺癌风险增加2.4倍（95% CI，1.4 - 4.3）。FH和AH同时存在对乳腺癌风险有很强的协同作用。