Risk factors for breast cancer development by tumor characteristics among women with benign breast disease

Abstract

Background Among women diagnosed with invasive breast cancer, 30% have a prior diagnosis of benign breast disease (BBD). Thus, it is important to identify factors among BBD patients that elevate invasive cancer risk. In the general population, risk factors differ in their associations by clinical pathologic features; however, whether women with BBD show etiologic heterogeneity in the types of breast cancers they develop remains unknown. Methods Using a nested case-control study of BBD and breast cancer risk conducted in a community healthcare plan (Kaiser Permanente Northwest), we assessed relationships of histologic features in BBD biopsies and patient characteristics with subsequent breast cancer risk and tested for heterogeneity of associations by estrogen receptor (ER) status, tumor grade, and size. The study included 514 invasive breast cancer cases (median follow-up of 9 years post-BBD diagnosis) and 514 matched controls, diagnosed with proliferative or non-proliferative BBD between 1971 and 2006, with follow-up through mid-2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using multivariable polytomous logistic regression models. Results Breast cancers were predominantly ER-positive (86%), well or moderately differentiated (73%), small (74% < 20 mm), and stage I/II (91%). Compared to patients with non-proliferative BBD, proliferative BBD with atypia conferred increased risk for ER-positive cancer (OR = 5.48, 95% CI = 2.14–14.01) with only one ER-negative case, P-heterogeneity = 0.45. The presence of columnar cell lesions (CCLs) at BBD diagnosis was associated with a 1.5-fold increase in the risk of both ER-positive and ER-negative tumors, with a 2-fold increase (95% CI = 1.21–3.58) observed among postmenopausal women (56%), independent of proliferative BBD status with and without atypia. We did not identify statistically significant differences in risk factor associations by tumor grade or size. Conclusion Most tumors that developed after a BBD diagnosis in this cohort were highly treatable low-stage ER-positive tumors. CCL in BBD biopsies may be associated with moderately increased risk, independent of BBD histology, and irrespective of ER status.

Genetic predisposition of HER2 gene polymorphisms (rs1136200 and rs1058808) associated with breast fibroadenoma in the South Indian population: A pilot case-control study

“…Several studies have suggested that rs1136200 polymorphisms in the HER2 gene may be genetic risk factors for breast broadenoma in South Indians. However, some evidence indicates that the polymorphism rs1058808 is not a signi cant risk factor [29]. Finally, this research has certain limitations.…”

Need assessment for the content of educational programs about breast cancer from the viewpoint of unaffected women

“…These programs might not contain the answer to their questions, because to our knowledge, no study has investigated this issue up to now. On the other side, in patients affected by known high-risk benign breast diseases, the approach and management offered by the health-care provider gives some significant information to the patients [14,26]. A literature search, however, shows no specific study aiming at the knowledge gaps in this group.…”

“…This is only made possible when the patient seeks medical help in the early stages, which means before the appearance of any symptom, or as early as the first manifestations [10]. On the other hand, some lesions of the breast precede the manifestation of breast cancer, and timely diagnosis of these precancerous lesions can assist in breast cancer prevention [11][12][13][14]. For this early detection to happen, it is necessary for women to be examined in appropriate times but this will only be possible if women are aware of this necessity.…”

Identification of a cuproptosis related chromatin regulators signature for lung adenocarcinoma

“…A growing body of literature has long shown that mRNAs, miRNAs, lncRNAs, and circRNAs can be used as diagnostic and prognostic biomarkers for certain cancers [23,24,25,26,27,28]. Genetic signature-based risk models have also been widely reported to show high prognostic accuracy in many other cancer types [29,30,31,32]. For example, in Sun's research, ROC curves showed that the AUC of hsa circ 0035445 was 0.68 and 0.86 in tissues and plasma respectively, suggesting hsa circ 0035445 had the potential in distinguishing tumor tissues from normal tissues [33].…”