Positive Association of Fibroadenomatoid Change with HER2-Negative Invasive Breast Cancer: A Co-Occurrence Study

Abstract

BackgroundRisk assessment of a benign breast disease/lesion (BBD) for invasive breast cancer (IBC) is typically done through a longitudinal study. For an infrequently-reported BBD, the shortage of occurrence data alone is a limiting factor to conducting such a study. Here we present an approach based on co-occurrence analysis, to help address this issue. We focus on fibroadenomatoid change (FAC), an under-studied BBD, as our preliminary analysis has suggested its previously unknown significant co-occurrence with IBC.MethodsA cohort of 1667 female patients enrolled in the Clinical Breast Care Project was identified. A single experienced breast pathologist reviewed all pathology slides for each case and recorded all observed lesions, including FAC. Fibroadenoma (FA) was studied for comparison since FAC had been speculated to be an immature FA. FA and Fibrocystic Changes (FCC) were used for method validation since they have been comprehensively studied. Six common IBC and BBD risk/protective factors were also studied. Co-occurrence analyses were performed using logistic regression models.ResultsCommon risk/protective factors were associated with FA, FCC, and IBC in ways consistent with the literature in general, and they were associated with FAC, FA, and FCC in distinct patterns. Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC. We report for the first time that FAC is positively associated with IBC with odds ratio (OR) depending on BMI (OR = 6.78, 95%CI = 3.43-13.42 at BMI<25 kg/m2; OR = 2.13, 95%CI = 1.20-3.80 at BMI>25 kg/m2). This association is only significant with HER2-negative IBC subtypes.ConclusionsWe conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA. Co-occurrence analysis can be used for initial assessment of the risk for IBC from a BBD, which is vital to the study of infrequently-reported BBDs.

Breast lesions in women under 25 years: radiologic-pathologic correlation

“…In our 2 cases of lactating adenoma, patients were lactating in the age group 21-25 years and this agrees with Coffin [21] that revealed lactating adenomas predominantly consist of lobules with lactational changes that develop in late pregnancy. Fibroadenomatoid hyperplasia and adenomyoepithelioma are rare benign breast lesions [22,23];…”

PCA-PAM50 improves consistency between breast cancer intrinsic and clinical subtyping reclassifying a subset of luminal A tumors as luminal B

“…As mentioned elsewhere in previous CBCP publication 42 in house data collection was conducted in accordance with a minimal risk protocol entitled “Tissue and Blood Library Establishment for Molecular, Biochemical and Histologic Study of Breast Disease”, approved by the IRB of the Walter Reed National Military Medical Center (IRBNet #20704) for the CBCP. Written informed consent was given by participants for use of their medical records and additional data collected through the CBCP questionnaires and data forms.…”