Stratification of Breast Cancer Risk in Women With Atypia: A Mayo Cohort Study

• DOI: 10.1200/jco.2006.09.0217
• Publication Date: 2007-06-12T20:23:04Z
• Authors: Amy C. Degnim; Daniel W. Visscher; Hal K. Berman; Marlene H. Frost; Thomas A. Sellers; Robert A. Vierkant; Shaun D. Maloney; V. Shane Pankratz; Piet C. de Groen; Wilma L. Lingle; Karthik Ghosh; Lois Penheiter; Thea Tlsty; L. Joseph Melton; Carol A. Reynolds; Lynn C. Hartmann
• Keywords: Risk Stratification; Atypia

Purpose Atypical hyperplasia is a well-recognized risk factor for breast cancer, conveying an approximately four-fold increased risk. Data regarding long-term absolute and factors stratification are needed. Patients Methods Women with atypical in the Mayo Benign Breast Disease Cohort were identified through pathology review. Subsequent cancers via medical records questionnaire. Relative risks (RRs) estimated using standardized incidence ratios, comparing observed number of those expected based on Iowa Surveillance, Epidemiology, End Results (SEER) data. Age, histologic factors, family history evaluated as modifiers. Plots cumulative cancer provided estimates over time. With mean follow-up 13.7 years, 66 (19.9%) occurred among 331 women atypia. RR atypia was 3.88 (95% CI, 3.00 to 4.94). Marked elevations seen multifocal (eg, three or more foci calcifications [RR, 10.35; 95% 6.13 16.4]). higher younger (< 45; RR, 6.76; 3.24 12.4). Risk similar ductal lobular hyperplasia, added no significant remained elevated 20 approached 35% at 30 years. Conclusion Among multiple presence may indicate “very high risk” status (> 50% years). A positive does not further increase