A multi-center prospective cohort study of benign breast disease and risk of subsequent breast cancer

Cancer Causes Control. 2010 Jun;21(6):821-8. doi: 10.1007/s10552-010-9508-7. Epub 2010 Jan 19.


Objective: We used a nested case-control design within a large, multi-center cohort of women who underwent a biopsy for benign breast disease (BBD) to assess the association of broad histologic groupings and specific histologic entities with risk of breast cancer.

Methods: Cases were all women who had a biopsy for BBD and who subsequently developed breast cancer; controls were individually matched to cases and were women with a biopsy for BBD who did not develop breast cancer in the same follow-up interval as that for the cases. After exclusions, 1,239 records (615 cases and 624 controls) were available for analysis. We used conditional logistic regression to estimate odds ratios and 95% confidence intervals (CIs).

Results: Relative to non-proliferative BBD/normal pathology, the multivariable-adjusted odds ratio for proliferative lesions without atypia was 1.45 (95% CI 1.10-1.90), and that for atypical hyperplasia was 5.27 (95% CI 2.29-12.15). The presence of multiple foci of columnar cell hyperplasia and of complex fibroadenoma without atypia was associated with a non-significantly increased risk of breast cancer, whereas sclerosing adenosis, radial scar, and papilloma showed no association with risk.

Conclusion: Our results indicate that, compared to women with normal pathology/non-proliferative disease, women with proliferative disease without atypia have a modestly increased risk of breast cancer, whereas women with atypical hyperplasia have a substantially increased risk.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Biopsy / adverse effects
  • Breast Diseases* / complications
  • Breast Diseases* / genetics
  • Breast Diseases* / pathology
  • Breast Neoplasms / etiology*
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / pathology
  • Cicatrix / complications
  • Cicatrix / genetics
  • Cicatrix / pathology
  • Cohort Studies
  • Female
  • Fibroadenoma / complications
  • Fibroadenoma / genetics
  • Fibroadenoma / pathology
  • Fibrocystic Breast Disease / complications
  • Fibrocystic Breast Disease / genetics
  • Fibrocystic Breast Disease / pathology*
  • Humans
  • Hyperplasia / complications
  • Logistic Models
  • Odds Ratio
  • Papilloma / complications
  • Papilloma / genetics
  • Papilloma / pathology
  • Precancerous Conditions / complications
  • Precancerous Conditions / genetics
  • Precancerous Conditions / pathology
  • Prospective Studies
  • Risk Factors