A recent cohort study published in JAMA Surgery has identified a link between benign breast disease diagnosed via percutaneous biopsies and an increased risk of breast cancer among women compared to the general population.
The study, led by Dr. Mark E. Sherman from the Mayo Clinic in Jacksonville, Florida, delves into the implications of changes in diagnostic methods and breast cancer risk factors since 2000. The shift from film-based mammography and surgical biopsy to digital mammography and percutaneous biopsy, along with changes in lifestyle factors like increased obesity and delayed age at first birth, prompted an exploration into the frequency of benign breast disease lesions and their associations with breast cancer risk.
The retrospective cohort study included data from 4,819 women with benign breast disease diagnosed at Mayo Clinic between 2002 and 2013. Participants were followed from 6 months after biopsy collection until censoring, breast cancer diagnosis, or December 2021. The breast cancer risk for women with benign breast disease was compared to the general population using female breast cancer incidence rates from the Iowa Surveillance, Epidemiology, and End Results (SEER) program.
Results indicated that women with benign breast disease faced a higher overall breast cancer risk compared to the general population (standard incidence ratio [SIR] = 1.95; 95% CI, 1.76-2.17). The risk increased with the severity of benign breast disease, with SIR values of 1.42 for nonproliferative lesions, 2.19 for proliferative disease without atypia, and 3.91 for atypical hyperplasia.
In terms of breast cancer types, the study revealed increased risks for invasive breast cancer (SIR = 1.56) and ductal carcinoma in situ (SIR = 3.1) among women with benign breast disease compared to the general population.
Additionally, breast cancer risk rose with lesion multiplicity, with 10-year cumulative breast cancer incidence rates of 4.3% for nonproliferative lesions, 6.6% for proliferative disease without atypia, and 14.6% for atypical hyperplasia, compared to the expected population cumulative incidence of 2.9%.
The researchers emphasized that while the exhaustive analysis conducted in the study might not be practical in routine diagnostic practice, advancements in digital imaging and computational pathology approaches could enable more comprehensive analysis of benign breast disease biopsy specimens, potentially improving breast cancer risk prediction in the future.
