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No elevation in long‐term breast carcinoma risk for women with fibroadenomas that contain atypical hyperplasia
Author(s) -
Carter Beverley A.,
Page David L.,
Schuyler Peggy,
Parl Fritz F.,
Simpson Jean F.,
Jensen Roy A.,
Dupont William D.
Publication year - 2001
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20010701)92:1<30::aid-cncr1288>3.0.co;2-2
Subject(s) - fibroadenoma , atypia , medicine , breast fibroadenoma , atypical hyperplasia , carcinoma , breast carcinoma , parenchyma , breast cancer , pathology , gynecology , cancer
BACKGROUND The authors previously showed that women with a fibroadenoma have a relative risk of invasive breast carcinoma of approximately 2.0 compared with women of similar age from the general population. This relative risk approaches 1.0 when family history and proliferative changes in the adjacent parenchyma are removed and rises to > 3.0 if the fibroadenoma has complex histology. The risk for developing breast carcinoma in women with atypical lobular hyperplasia (ALH) and atypical ductal hyperplasia (ADH) or their minimal variants within a fibroadenoma is unknown. METHODS The authors conducted a long‐term, retrospective cohort study of 1834 women with adequate follow‐up who presented with fibroadenoma at three local hospitals between 1950 and 1968. Histology was reviewed using established criteria, and the patients were categorized with ALH, ADH, minimal atypia, or no atypia. RESULTS The overall prevalence of ALH or ADH within fibroadenomas was 0.81%. Minimal or true atypia within a fibroadenoma appeared to be correlated with proliferative disease in the adjacent parenchyma but could not predict for the presence there of well‐established atypia. Only 7% of women with well‐developed atypia developed invasive carcinoma on follow‐up. Three women with minimal atypia developed invasive carcinoma. CONCLUSIONS In this study of a large cohort of women with fibroadenoma, the authors found that atypia within a fibroadenoma cannot predict for the presence of atypia within adjacent breast parenchyma. They also found that atypia confined to a fibroadenoma does not incur a clinically meaningful risk of future breast carcinoma development greater than that of fibroadenoma alone. Cancer 2001;92:30–6. © 2001 American Cancer Society.