Benign Breast Diseases in Breast Cancer Screening Programs in Italy (2000-2001)

Fabbri, Sandra; Perfetti, Elisa; Govoni, Deanna; Bianchi, Simonetta; Brancato, Beniamino; Paci, Euǵenio

doi:10.1177/030089160409000602

Cited by 4 publications

(7 citation statements)

References 4 publications

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“…33 In screening activities, the role of breast lesions at risk of developing cancer needs to be redefined. In accordance with other authors, 33,34 we believe that it is inappropriate to include breast lesions at risk of developing cancer in the overall benign open biopsy rate and that it is time to define a screening performance indicator that audits the detection of these lesions.…”

supporting

confidence: 74%

“…Fibroadenoma and fibrocystic disease were the most frequent lesions included in the current and previously published series 31,32,34,52 (Table 6). Previous studies on screening series have demonstrated that greater numbers of 'pure' benign lesions are being excised 31,32 ( Table 5), but the increasing accuracy of preoperative diagnosis after the introduction of needle biopsy probably will lead to a decrease in this number over time.…”

mentioning

confidence: 77%

“…Burnett et al 32 reported that 16.1% of lesions were atypical epithelial hyperplasia (AH) in a series of 137 benign screening biopsies (Table 5); in 4 of 22 lesions, AH was associated with RS, and, in 1 lesion, AH was within an adenomyoepithelioma. The data on benign breast open biopsies that were reported in the annual survey of Italian Mammographic Screening Programs 34 indicated that the ADH rate accounted for 6.3% of lesions detected in prevalent screening and 4.5% of lesions detected in incident screening and that the ALH rate accounted for 1.3% and 3.3% of lesions detected in prevalent and incident screening, respectively. In the current series, 31.3% of benign open biopsies (26 of 83 biopsies) were performed on benign breast lesions that were at low risk of developing malignancy (Histo3 category) ( Table 4).…”

Section: Histology 4 Category: Benign Proliferative Lesions With Highmentioning

confidence: 99%

“…One patient without mammographic suspicious lesion (BIRADS score, 1) had nonspontaneous nipple discharge. [31][32]34 (Table 5). In the current benign surgical biopsy screening series, 57.8% of lesions were proliferative lesions that were at risk of developing cancer ( Table 4).…”

Section: Histology 4 Category: Benign Proliferative Lesions With Highmentioning

confidence: 99%

“…Only a few studies have analyzed the impact of proliferative breast lesions at risk of developing cancer on the benign open biopsy rate in screening programs. [31][32][33][34] The current report describes the histologic types of benign lesions in open biopsies performed in the Breast Cancer Screening Program of Verona (BCSPV) and defines the proportion of lesions at risk of developing cancer. The performance and impact indicators of BCSPV also were analyzed.…”

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confidence: 99%

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Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Manfrin

Mariotto

Remo

et al. 2009

Cancer

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BACKGROUND:Cytology and core‐needle biopsies are not always sufficient to exclude malignancy in benign breast lesions (BBL) that are at risk of developing cancer, and open biopsy often is mandatory. In screening programs, open biopsies performed for lesions that are at risk of developing malignancy are considered benign. The authors of this report evaluated the impact of the screen‐detected BBL at risk of developing cancer that were counted in the quota of benign breast open biopsies in the Breast Cancer Screening Program of Verona.METHODS:Benign open biopsies were subdivided into 4 groups according to their risk of developing cancer: Histo1, normal histology; Histo2, ‘pure’ BBL (fibroadenoma, fibrocystic disease, mastitis, adenosis); Histo3, BBL with a low risk of developing cancer (radial scar, papilloma, papillomatosis, phyllodes tumor, mucocele‐like lesion); and Histo4, BBL with a high risk of developing cancer (atypical columnar cell hyperplasia, atypical ductal hyperplasia, atypical lobular hyperplasia).RESULTS:Of 510 open biopsies, 83 biopsies were benign, and the ratio of benign to malignant biopsies was 1:5. Histo1 was observed in 4.8% of all benign open biopsies, Histo2 was observed in 37.4%, Histo3 was observed in 31.3%, and Histo4 was observed 26.5%.CONCLUSIONS:BBL at risk of developing cancer may be numerous in screening programs. It is inappropriate to include BBL at risk of developing cancer in the overall benign open biopsy rate. The authors propose separating pure BBL from lesions at higher risk of developing cancer. To date, there is no evidence to support the premise that detecting high‐risk proliferative lesions leads to benefits in terms of reduced mortality; however, these lesions need to be counted separately for future evaluations. Cancer 2009. © 2008 American Cancer Society.

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supporting

confidence: 74%

mentioning

confidence: 77%

Section: Histology 4 Category: Benign Proliferative Lesions With Highmentioning

confidence: 99%

Section: Histology 4 Category: Benign Proliferative Lesions With Highmentioning

confidence: 99%

mentioning

confidence: 99%

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Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Manfrin

Mariotto

Remo

et al. 2009

Cancer

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Human epithelial growth factor receptor 2[Ile655Val] polymorphism and risk of breast fibroadenoma

Žúbor

Kajo²,

Stanclova³

et al. 2008

European Journal of Cancer Prevention

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Studies on the association between the Ile to Val polymorphism at codon 655 of the human epithelial growth factor receptor 2 (HER-2) gene and susceptibility to breast cancer have been reported for almost all ethnic populations, with both positive or negative conclusions. No study, however, has yet been focused on the possible association between this gene and its predisposition to benign breast lesions, especially on risk for fibroadenoma. We aimed to study the association of the single nucleotide polymorphism V655 HER-2 gene polymorphism with histologically verified breast fibroadenoma risk. We conducted a molecular epidemiological case-control study of 70 breast fibroadenoma cases without cellular atypia and 172 healthy female controls. We found that the Val variant allele and genotype frequency of this polymorphism is higher in cases with fibroadenoma; however, this difference was not significant (allele Val 655: 27.86 and 22.67% in fibroadenoma and controls, respectively; genotype Ile/Val: 35.71 and 38.37% and Val/Val: 10.0 and 3.49% in fibroadenoma and controls, respectively). Applying logistic regression analysis, we found an increased risk of fibroadenoma formation in carriers of the Val allele (odds ratio = 1.17; 95% confidence interval = 0.67-2.05), in which the highest risk was associated with homozygous genotype (odds ratio = 3.07; 95% confidence interval = 0.97-9.72), but this risk was not significant. Stratification by age (cut-off 45 years) revealed the highest risk of fibroadenoma among young women homozygous for the Val allele (odds ratio = 3.30). The risk, however, was slightly increased (odds ratio = 1.24) among older carriers of the aberrant allele in their genotype as well, but it was not significant. In spite of insignificant differences, our results indicate that HER-2 Ile655Val polymorphism, especially in a homozygous form might play some role in the etiology of breast fibroadenoma formation. The significance of this susceptibility, however, will have to be verified by larger studies.

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Breast Cancer Diagnostic Methods: Screen-Detected and Clinical Cases. An Italian Survey of Women's Experiences

Rossi

Camilloni

Mantellini

et al. 2007

Tumori

Self Cite

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Aims and Background The real practice of breast cancer diagnosis and treatment is often very different from guideline recommendations. Screening programs should minimize deviations from “best practice”. The aim of the study was to compare cases detected by screening programs with cases that were not part of the public screening program, analyzing the diagnostic pathways from the first suspected breast problem to therapeutic intervention for breast cancer. Methods We interviewed a random sample of 268 women aged 49–70 years in three Italian regions (Lazio, Tuscany, Basilicata) who were treated for breast cancer, stratified by screening participation. Results In the nonscreened group, 48% of women were symptomatic and 50% were diagnosed by preventive tests. The proportion of women treated within 30 days of diagnosis was significantly lower in the screened group, 21.3% vs 35.8% (P = 0.0003). The mean number of tests (mammography, ultrasonography, cytology and histology) performed in the screened group was significantly higher than in the nonscreened group, 3.7 vs 2.8 (P = 0.001). The percentage of women treated without a preoperative histological or cytological diagnosis was lower in the screened group than in the nonscreened group, 14% vs 25% (P = 0.024). Conclusion Participation in screening programs seems to lead to more appropriate disease management even for breast cancer cases treated at the same hospital.

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Benign Breast Diseases in Breast Cancer Screening Programs in Italy (2000-2001)

Cited by 4 publications

References 4 publications

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Human epithelial growth factor receptor 2[Ile655Val] polymorphism and risk of breast fibroadenoma

Breast Cancer Diagnostic Methods: Screen-Detected and Clinical Cases. An Italian Survey of Women's Experiences

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