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Extent of atypical hyperplasia stratifies breast cancer risk in 2 independent cohorts of women
Author(s) -
Degnim Amy C.,
Dupont William D.,
Radisky Derek C.,
Vierkant Robert A.,
Frank Ryan D.,
Frost Marlene H.,
Winham Stacey J.,
Sanders Melinda E.,
Smith Jeffrey R.,
Page David L.,
Hoskin Tanya L.,
Vachon Celine M.,
Ghosh Karthik,
Hieken Tina J.,
Denison Lori A.,
Carter Jodi M.,
Hartmann Lynn C.,
Visscher Daniel W.
Publication year - 2016
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/cncr.30153
Subject(s) - medicine , relative risk , breast cancer , cohort , atypical hyperplasia , hyperplasia , risk factor , cancer , gynecology , biopsy , histology , gastroenterology , confidence interval
BACKGROUND Women with atypical hyperplasia (AH) on breast biopsy have a substantially increased risk of breast cancer (BC). Here the BC risk for the extent and subtype of AH is reported for 2 separate cohorts. METHODS All samples containing AH were included from 2 cohorts of women with benign breast disease (Mayo Clinic and Nashville). Histology review quantified the number of foci of atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH). The BC risk was stratified for the number of AH foci within AH subtypes. RESULTS The study included 708 Mayo AH subjects and 466 Nashville AH subjects. In the Mayo cohort, an increasing number of foci of AH was associated with a significant increase in the risk of BC both for ADH (relative risks of 2.61, 5.21, and 6.36 for 1, 2, and ≥3 foci, respectively; P for linear trend = .006) and for ALH (relative risks of 2.56, 3.50, and 6.79 for 1, 2, and ≥3 foci, respectively; P for linear trend = .001). In the Nashville cohort, the relative risks of BC for ADH were 2.70, 5.17, and 15.06 for 1, 2, and ≥3 foci, respectively ( P for linear trend < .001); for ALH, the relative risks also increased but not significantly (2.61, 3.48, and 4.02, respectively; P = .148). When the Mayo and Nashville samples were combined, the risk increased significantly for 1, 2, and ≥3 foci: the relative risks were 2.65, 5.19, and 8.94, respectively, for ADH ( P < .001) and 2.58, 3.49, and 4.97, respectively, for ALH ( P = .001). CONCLUSIONS In 2 independent cohort studies of benign breast disease, the extent of atypia stratified the long‐term BC risk for ADH and ALH. Cancer 2016;122:2971‐2978 . © 2016 American Cancer Society .