RESUMO
Sjögren's syndrome is an autoimmune disease with the chronic inflammation of glandular tissues, typically salivary and lacrimal glands. Since mammary tissue shares the glandular structure, Sjögren's syndrome may also target mammary tissue to cause breast diseases. We therefore determined whether primary Sjögren's syndrome (pSS) is associated with the increased risk of breast cancer (BC) and breast fibrocystic change (FC). Total 282 female patients with pSS were recruited from a medical center in Taiwan, and patients' medical records were reviewed to identify BC and ultrasonographic breast FC. The prevalence, incidence and risk factors for BC and breast FC in pSS patients were determined, and the risk factors for these breast diseases were subsequently analyzed. Our results showed that pSS patients had the increased prevalence and incidence of BC, and high anti-SSA(Ro) antibody titers were found to be associated with the increased risk of BC. Breast FC was also found highly prevalent in these patients. Comorbidity analysis as risk factor for BC in pSS patients showed diabetes mellitus was strongly associated with the increased risk of BC (odds ratioâ =â 10.4, Pâ =â .0006), whereas breast FC was inversely associated with the risk of BC (odds ratioâ =â 0.077 Pâ =â .0158). These data indicated that pSS is association with the increased risk of BC and with the high prevalence of ultrasonographic breast FC. Our results also suggest that, in pSS patients, the high anti-SSA(Ro) antibody titers and diabetes mellitus confer the increased risk of BC, whereas the absence of ultrasonographic breast FC predicts the higher risk of BC.
Assuntos
Neoplasias da Mama , Diabetes Mellitus , Doença da Mama Fibrocística , Síndrome de Sjogren , Humanos , Feminino , Síndrome de Sjogren/complicações , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/complicações , Doença da Mama Fibrocística/epidemiologia , Medição de RiscoRESUMO
Background: Distinguishing benign breast diseases (BBDs) from malignant breast diseases is a worrisome entity and should also have knowledge of the pattern of occurrence of the disorders in their geographical location. This research aimed to study the clinical and histopathological pattern of BBD in Indian patients. Materials and Methods: The study was conducted on 153 specimens from lumpectomy, core needle biopsy, and mastectomy. Data regarding patients' age, sex, presenting complaints, duration of the complaints, and history of menstrual cycles and lactation were collected from the biopsy requisition forms and case papers. The tissue bits were processed and stained with hematoxylin and eosin, and a histopathological examination was performed. Results: Most of the patients in the present study were females (n = 151, 98.7%). The mean age of the patients was 30.45 years. Most of the BBD cases (n = 118, 77.14%) were benign, of which fibroadenoma (101 cases) accounted for 66%. Majority of the lesions were in the upper outer quadrant (39.22%). Of the 153 cases, 94 cases of fibroadenoma, one case of breast abscess, nine cases of fibrocystic change, four cases of phyllodes, three cases of lipoma, and one case of gynecomastia diagnosed clinically correlated well with histopathology (n = 112, 73%). Conclusion: BBDs are mostly seen in female patients in the age group of 21-30 years. Fibroadenoma is the most common BBD. Clinical assessment followed by histopathological examination provided an accurate diagnosis. The clinical diagnosis correlated well with histopathology.
Assuntos
Doenças Mamárias , Neoplasias da Mama , Fibroadenoma , Doença da Mama Fibrocística , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/cirurgia , Neoplasias da Mama/epidemiologia , Fibroadenoma/diagnóstico , Fibroadenoma/cirurgia , Centros de Atenção Terciária , Mastectomia , Doenças Mamárias/diagnóstico , Doenças Mamárias/cirurgia , Doença da Mama Fibrocística/diagnóstico , Doença da Mama Fibrocística/cirurgia , Doença da Mama Fibrocística/epidemiologiaRESUMO
AIM: To investigate the association between SRA1 rs801460 and rs10463297 variants and proliferative type of benign breast disease with atypia development in Ukrainian females. MATERIALS AND METHODS: 83 individuals diagnosed with proliferative type of benign breast disease with atypia and 115 without atypia were enrolled in the study. The rs801460 and rs10463297 variants genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism analysis. Hematoxylin and eosin, toluidine blue and van Gieson's picrofuchsin methods were used for sections staining. RESULTS: It was revealed that SRA1 rs801460-variant is associated with proliferative type of benign breast disease with atypia development both before and after adjustment for risk factors (age, body mass index, age of menarche, oral contraceptives intake and burdened history of breast cancer). The risk for mentioned disease in the individuals with rs801460 TT-genotype is 2.2 times higher (confidence interval 1.010-4.800; p = 0.047) than in individuals with the CC and CT genotypes. No link between SRA1 rs10463297 and proliferative type of benign breast disease with atypia occurrence in Ukrainian females was found. CONCLUSION: The present study specified that SRA1 rs801460, but not rs10463297, can be the strong genetic predictor for benign breast disease with atypia in Ukrainian females.
Assuntos
Neoplasias da Mama , Proteínas de Transporte/genética , Doença da Mama Fibrocística , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Etnicidade , Feminino , Doença da Mama Fibrocística/complicações , Doença da Mama Fibrocística/epidemiologia , Genótipo , Humanos , Fatores de Risco , UcrâniaRESUMO
OBJECTIVES: We investigated the association of personal, reproductive, and familial characteristics with bilateral oophorectomy performed for nonmalignant indications in a US population. STUDY DESIGN: In an established cohort study, we used the records-linkage system of the Rochester Epidemiology Project (REP http://www.rochesterproject.org) to identify 1653 premenopausal women who underwent bilateral oophorectomy in Olmsted County, Minnesota between 1988 and 2007 for a nonmalignant indication. Each woman was matched by age (±1 year) to a population-based referent woman who had not undergone bilateral oophorectomy as of the index date. We used case-control analyses to investigate several characteristics associated with bilateral oophorectomy. Odds ratios and their 95% confidence intervals were adjusted for race, education, and income. RESULTS: In the overall analyses, infertility was more common in women who underwent bilateral oophorectomy than in the controls, whereas use of oral contraceptives, a history of breast feeding, and fibrocystic breast disease were less common. The women who underwent bilateral oophorectomy weighed more than controls, had a higher body mass index and were younger at menarche. The associations were more pronounced for women who underwent the bilateral oophorectomy before age 46 years, and some associations were different for women with or without a benign ovarian indication. Reported family histories of uterine and other cancers were more common in women without a benign ovarian indication. CONCLUSIONS: We identified a number of personal, reproductive, and familial characteristics that were associated with bilateral oophorectomy over a 20-year period. Our historical findings may help inform decision-making about oophorectomy in the future.
Assuntos
Ovariectomia , Pré-Menopausa , Adulto , Índice de Massa Corporal , Aleitamento Materno , Estudos de Casos e Controles , Características da Família , Feminino , Doença da Mama Fibrocística/epidemiologia , Humanos , Anamnese , Menarca , Pessoa de Meia-Idade , Minnesota/epidemiologia , Razão de Chances , ReproduçãoRESUMO
As life expectancy is on the rise, it is predicted that a growing number of people will live beyond the age of 65 and therefore a higher number of elderly women will have breast diseases requiring significant health care and services. This study is aimed at investigating the characteristics, the treatment and outcomes of women older than 65 years old treated for breast diseases at our institution. This was a retrospective study covering the period from January 2003 to December 2011. It involved 92 patients aged over 65 and treated for breast disease in the Maternity Center of Monastir, Tunisia. The data included characteristics of patients and tumors, treatment and outcomes that were obtained through data extraction sheets. We reported a study of 92 women over the age of 65 of whom 77 women had malignant breast disease (83.6%) and 15 benign breast diseases (16.4%). Breast cancer was discovered at a mean age of 72.5 ± 6.6 years. Distant metastases were found in 5.3% of cases and infiltrative ductal carcinoma was detected in 85.7% of patients. Hormonal receptors were positive for estrogens in 64.7% of cases. Surgical treatment was performed in 73 patients and adjuvant treatment was prescribed for 67 women (86%). The complication rate was 16.6% among the 73 patients who underwent surgery. Benign breast diseases represented 16.3% of the mammary pathologies. Abscesses and fibrocystic mastopathy were the most frequent histological diagnoses. Despite great interest in geriatric gynecological pathology worldwide, many questions related to how optimally treat this patient population remain unanswered. In this study, a surgical treatment was performed in 94.8% of breast cancer patients and the complication rate was 16.6%.
Assuntos
Abscesso/epidemiologia , Doenças Mamárias/epidemiologia , Neoplasias da Mama/epidemiologia , Doença da Mama Fibrocística/epidemiologia , Abscesso/terapia , Idoso , Idoso de 80 Anos ou mais , Doenças Mamárias/patologia , Doenças Mamárias/terapia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Feminino , Doença da Mama Fibrocística/terapia , Humanos , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Tunísia/epidemiologiaRESUMO
Equol (a bacterial metabolite of the soy isoflavone daidzein) is produced by 30% to 50% of humans and may be associated with health outcomes. We hypothesized that plasma equol would be inversely associated with risks of fibrocystic breast conditions (FBC) and breast cancer (BC). Plasma from women in a breast self-examination trial in Shanghai with BC (n=269) or FBC (n=443), and age-matched controls (n=1027) was analyzed for isoflavones. Equol was grouped into categories (<20, 20-<45, and ≥45nmol/L) and, among women with daidzein ≥20nmol/L, the log10 equol:daidzein ratio was grouped into tertiles. Where available, non-cancerous tissue (NCT) adjacent to the carcinomas from women with BC were classified as non-proliferative or proliferative (n=130 and 172, respectively). The lesions from women with FBC were similarly classified (n=99 and 92, respectively). Odds ratios (OR) and 95% confidence intervals (CI) were calculated across equol categories and tertiles of log10 equol:daidzein ratio. Equol categories were not associated with FBC or BC (P>.05). For log10 equol:daidzein, compared to controls there were positive associations in the mid tertile for proliferative FBC (OR 2.06, 95% CI 1.08-3.93), BC with proliferative NCT (OR 2.95, 95% CI 1.37-6.35), and all BC regardless of histology (OR 2.37, 95% CI 1.43-3.95). However, trends in ORs with increasing plasma equol values or equol:daidzein ratios were not observed (P>.05). The results of this study do not provide evidence that equol plays a role in the etiology of these breast conditions. However, further work is needed to confirm or refute this conclusion.
Assuntos
Neoplasias da Mama/sangue , Equol/sangue , Doença da Mama Fibrocística/sangue , Adulto , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Autoexame de Mama , Estudos de Casos e Controles , China/epidemiologia , Feminino , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/patologia , Humanos , Isoflavonas/sangue , Pessoa de Meia-Idade , Razão de ChancesRESUMO
Mucocele-like lesions (MLLs) of the breast are characterized by cystic architecture with stromal mucin and frequent atypia, but it is unknown whether they convey long-term breast cancer risk. We evaluated 102 MLLs that were derived from a single-institution benign breast disease cohort of 13412 women who underwent biopsy from 1967 to 2001. MLLs were histologically characterized by type of lining epithelium, architecture of the lesion, associated atypical hyperplasia (AH), and incidence of breast cancer (14.8-year median follow-up). A relatively large proportion of MLLs (42%) were diagnosed in women older than 55 years. AH was significantly more frequent in MLL patient compared to the cohort overall (27% versus 5%; P < .001). Breast cancer has developed in 13 patients with MLL. This frequency is only slightly higher than population expected rates overall (standardized incidence ratio, 2.28; 95% confidence interval, 1.21-3.91) and not significantly different from women in the cohort with (nonatypical) proliferative breast lesions. Younger women (<45) with MLL had a nonsignificant increase in risk of cancer compared to the general population (standardized incidence ratio, 5.16; 95% confidence interval, 1.41-13.23). We conclude that MLL is an uncommon breast lesion that is often associated with coexisting AH. However, in women older than 45 years, MLLs do not convey additional risk of breast cancer beyond that associated with the presence of proliferative disease.
Assuntos
Cisto Mamário/patologia , Neoplasias da Mama/patologia , Mama/patologia , Doença da Mama Fibrocística/patologia , Mucocele/patologia , Adulto , Fatores Etários , Biópsia , Cisto Mamário/epidemiologia , Neoplasias da Mama/epidemiologia , Proliferação de Células , Feminino , Doença da Mama Fibrocística/epidemiologia , Humanos , Hiperplasia , Incidência , Pessoa de Meia-Idade , Minnesota/epidemiologia , Mucocele/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
AIM: Fibrocystic mastosis (FCM) is defined by the totality of dystrophic changes of the mammary tissue, the grouping in the form of fibrosis of epithelial, cystic, metaplastic and hyperplastic alterations. A very good estimation of the cancer risk is related specifically to the microscopic aspect. Other factors, the family history as well as the presence of an inherited gene determining the increase in the risk of breast cancer are also considered. But, if a woman known with fibrocystic mastosis has not undergone any biopsy, then it is impossible to calculate the specific individual risk of developing cancer. MATERIAL AND METHODS: The data collected as a study material and considered refer to: the total num- ber of cases investigated and diagnosed with fibrocystic mastosis, the annual distribution of this disease cases, the distribution of the cases according to age groups, admission reasons, clinical examination, personal pathologic history clinically significant for the basic disease (the main diagnosis), the family medical history significant for the basic disease, the anatomopathological diagnosis. RESULTS: Between 2004 and 2006, at "Cuza Voda" Obstetrics and Gynecology Hospital of Iasi, a maximum number of cases is noticed in 2006, when there were 147 cases, and the lowest number of cases was in 2005. There was high frequency of the anatomopathological examinations that highlighted the presence of fibrocystic lesions (both proliferative and non-proliferative), and the second most often diagnosis is fibroadenoma. Though fibrocystic mastosis is not clearly defined, it is still admitted that in order to support this diagnosis it is first compulsory to exclude malignant tumours. CONCLUSIONS: Only in 5% of the women with fibrocystic mastosis cellular changes can be revealed in the form of atypical hyperplasia, which are a risk factor for cancer. The lesion that delimits cancer from non-cancer is ductal carcinoma in situ. An incidence of over 20% is present in the countries that use mammographic screening programmes, mammographic surveillance programmes and programmes for the guided localization of nonpalpable lesions of the mammary gland.
Assuntos
Neoplasias da Mama/prevenção & controle , Fibroadenoma/prevenção & controle , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/patologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Idoso , Biópsia , Diagnóstico Diferencial , Detecção Precoce de Câncer , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Lesões Pré-Cancerosas , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Romênia/epidemiologiaRESUMO
Sector resection of the breast is the standard surgical treatment of benign breast disease, but often it has unsatisfactory outcomes. The aim of the study was a comparative analysis of the effectiveness of surgical treatment of patients with benign breast diseases after sector resection and after modification of the procedure. Classical sector resection was performed on 45 women, 106 - underwent operations with using of plastic surgery elements. The effectiveness of treatment was defined by the presence of complications in the early postoperative period; the quality of life was studied using questionnaires--The Short Form Medical Study (SF-36) and The Breast Evaluation Questionnaire (BEQ)--before surgery and after 3 and 12 months after surgery. After sector resection was 44% of the complications in the early postoperative period, after the developed techniques - 17%. 3 months after the operation quality of life and aesthetic satisfaction of breast in patients of both groups decreased. 1 year after sector resection the rates of satisfaction of breast aesthetic appearance were significantly lower than the preoperative level. In patients after modified operations at 1 year was observed a significant improvement in well-being and satisfaction of aesthetic appearance of breast. The method of sector resection has a greater number of complications; it leads to deterioration of the aesthetic appearance of the breast in 1 year after surgery. Surgery techniques with elements of mammaplasty have fewer complications and improve quality of life after surgery.
Assuntos
Neoplasias da Mama/cirurgia , Doença da Mama Fibrocística/cirurgia , Mamoplastia/métodos , Adolescente , Adulto , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Feminino , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/patologia , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Período Pós-Operatório , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Monocentric cohorts suggested that radiation-induced CD8 T-lymphocyte apoptosis (RILA) can predict late toxicity after curative intent radiotherapy (RT). We assessed the role of RILA as a predictor of breast fibrosis (bf +) after adjuvant breast RT in a prospective multicenter trial. METHODS: A total of 502 breast-cancer patients (pts) treated by conservative surgery and adjuvant RT were recruited at ten centers. RILA was assessed before RT by flow cytometry. Impact of RILA on bf + (primary endpoint) or relapse was assessed using a competing risk method. Receiver-operator characteristic (ROC) curve analyses were also performed in intention to treat. This study is registered with ClinicalTrials.gov, number NCT00893035 and final analyses are presented here. FINDINGS: Four hundred and fifty-six pts (90.8%) were included in the final analysis. One hundred and eight pts (23.7%) received whole breast and node irradiation. A boost dose of 10-16 Gy was delivered in 449 pts (98.5%). Adjuvant hormonotherapy was administered to 349 pts (76.5%). With a median follow-up of 38.6 months, grade ≥ 2 bf + was observed in 64 pts (14%). A decreased incidence of grade ≥ 2 bf + was observed for increasing values of RILA (p = 0.012). No grade 3 bf + was observed for patients with RILA ≥ 12%. The area under the ROC curve was 0.62. For cut-off values of RILA ≥ 20% and < 12%, sensitivity and specificity were 80% and 34%, 56% and 67%, respectively. Negative predictive value for grade ≥ 2 bf + was equal to 91% for RILA ≥ 20% and positive predictive value was equal to 22% for RILA < 12% where the overall prevalence of grade ≥ 2 bf + was estimated at 14%. A significant decrease in the risk of grade ≥ 2 bf + was found if patients had no adjuvant hormonotherapy (sHR = 0.31, p = 0.007) and presented a RILA ≥ 12% (sHR = 0.45, p = 0.002). INTERPRETATION: RILA significantly predicts the risk of breast fibrosis. This study validates the use of RILA as a rapid screening test before RT delivery and will change definitely our daily clinical practice in radiation oncology. FUNDING: The French National Cancer Institute (INCa) through the "Program Hospitalier de Recherche Clinique (PHRC)".
Assuntos
Apoptose/efeitos da radiação , Neoplasias da Mama/complicações , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Doença da Mama Fibrocística/diagnóstico , Doença da Mama Fibrocística/etiologia , Radioterapia Adjuvante/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/mortalidade , Neoplasias da Mama/radioterapia , Feminino , Doença da Mama Fibrocística/epidemiologia , Fibrose , Humanos , Incidência , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Recidiva , Fatores de RiscoRESUMO
Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.
Assuntos
Neoplasias da Mama/epidemiologia , Doença da Mama Fibrocística/epidemiologia , Mamografia , Neoplasias/epidemiologia , Fatores Etários , Idoso , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Detecção Precoce de Câncer , Feminino , Doença da Mama Fibrocística/diagnóstico por imagem , Doença da Mama Fibrocística/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Fatores de RiscoRESUMO
OBJECTIVES: To describe the histopathological patterns of benign breast diseases (BBD) among Saudi patients. METHODS: This is a retrospective review of BBD reports of Saudi patients of both genders and all age groups seen between January 2006 and December 2013 at King Fahad Hospital, Madinah, Kingdom of Saudi Arabia. RESULTS: Out of the total 1005 breast biopsies, 603 cases (60%) were BBD. The female to male ratio was 30.7:1. The overall mean age for BBD was 27.5 years, with an age range of 14-80 years. The most common lesion was fibroadenoma (FA) accounting for 44.3% of cases (mean age: 23.5 years), followed by 23.4% fibrocystic change (FCC) (mean age: 37.1 years). Both lesions had a peak occurrence in the third decade. Inflammatory lesions constituted 13.9% of cases. Most common were granulomatous mastitis (3.5%), chronic mastitis (3.3%), and acute mastitis with abscess (3.1%). Other major lesions encountered were fibroadenomatoid hyperplasia (3.1%), intraductal papilloma (2.8%), and benign phylloides tumor (2.6%). All benign diagnoses in male patients were gynecomastia and most patients (68.4%) were under 40 years. CONCLUSION: In this study, BBD constituted 60% of breast lumps, and were mostly FA and FCC. The BBD peaked at the 20-29 year age range.
Assuntos
Neoplasias da Mama/epidemiologia , Fibroadenoma/epidemiologia , Doença da Mama Fibrocística/epidemiologia , Ginecomastia/epidemiologia , Mastite/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Mamárias/epidemiologia , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Feminino , Fibroadenoma/patologia , Doença da Mama Fibrocística/patologia , Ginecomastia/patologia , Humanos , Masculino , Mastite/patologia , Pessoa de Meia-Idade , Papiloma Intraductal/epidemiologia , Papiloma Intraductal/patologia , Tumor Filoide/epidemiologia , Tumor Filoide/patologia , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Adulto JovemRESUMO
Atypical hyperplasia is a high-risk premalignant lesion of the breast, but its biology is poorly understood. Many believe that atypical ductal hyperplasia (ADH) is a direct precursor for low-grade ductal breast cancer, whereas atypical lobular hyperplasia (ALH) serves as a risk indicator. These assumptions underlie current clinical recommendations. We tested these assumptions by studying the characteristics of the breast cancers that develop in women with ADH or ALH. Using the Mayo Benign Breast Disease Cohort, we identified all women with ADH or ALH from 1967 to 2001 and followed them for later breast cancers, characterizing side of breast cancer versus side of atypia; time to breast cancer; type, histology, and grade of breast cancer, looking for patterns consistent with precursors versus risk indicators. A total of 698 women with atypical hyperplasia were followed a mean of 12.5 years; 143 developed breast cancer. For both ADH and ALH, there is a 2:1 ratio of ipsilateral to contralateral breast cancer. The ipsilateral predominance is marked in the first 5 years, consistent with a precursor phenotype for both ADH and ALH. For both, there is a predominance of invasive ductal cancers with 69% of moderate or high grade. Twenty-five percent are node positive. Both ADH and ALH portend risk for ductal carcinoma in situ and invasive breast cancers, predominantly ductal, with two thirds moderate or high grade. The ipsilateral breast is at especially high risk for breast cancer in the first 5 years after atypia, with risk remaining elevated in both breasts long term. ADH and ALH behave similarly in terms of later breast cancer endpoints.
Assuntos
Mama/patologia , Lesões Pré-Cancerosas/patologia , Adulto , Idoso , Biópsia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/patologia , Carcinoma Intraductal não Infiltrante/epidemiologia , Carcinoma Intraductal não Infiltrante/patologia , Progressão da Doença , Feminino , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/patologia , Humanos , Hiperplasia/epidemiologia , Hiperplasia/patologia , Estudos Longitudinais , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/epidemiologia , Fatores de TempoRESUMO
Over one million American women have a benign breast biopsy annually. Sclerosing adenosis (SA) is a common, but poorly understood benign breast lesion demonstrating increased numbers of distorted lobules accompanied by stromal fibrosis. Few studies of its association with breast cancer have been conducted, with contradictory results. We studied SA in the Mayo Benign Breast Disease (BBD) Cohort, which includes women who had benign biopsies at Mayo-Rochester 1967-2001. Breast cancer risk in defined subsets was assessed using standardized incidence ratios (SIRs), relative to the Iowa Surveillance, Epidemiology, and End Results registry. This BBD cohort of 13,434 women was followed for a median of 15.7 years. SA was present in 3,733 women (27.8 %) who demonstrated an SIR for breast cancer of 2.10 (95 % CI 1.91-2.30) versus an SIR of 1.52 (95 % CI 1.42-1.63) for the 9,701 women without SA. SA was present in 62.4 % of biopsies with proliferative disease without atypia and 55.1 % of biopsies with atypical hyperplasia. The presence of SA stratified risk in subsets of women defined by age, involution status, and family history. However, SA does not further stratify risk in women diagnosed with other forms of proliferative breast disease, either with or without atypia. SA is a common proliferative lesion of the breast which, as a single feature, conveys an approximate doubling of breast cancer risk. Its role in breast carcinogenesis remains undefined; its presence may aid in risk prediction for women after a breast biopsy.
Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Doença da Mama Fibrocística/complicações , Doença da Mama Fibrocística/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Esclerose/complicações , Adulto JovemRESUMO
We compared the relationships among percentage of body fat (%BF) and physical activity with breast cancer (BC) and benign breast diseases (BBD) in low-income Brazilian women. A case-control study including 106 incident BC cases, 178 incident BBD cases, and 181 control women recruited from a public hospital-based screening center was conducted. Logistic regression models showed that sedentary women have a higher odds of developing BC in the age adjusted model [odds ratio (OR) = 2.39, 95% confidence interval (CI) 1.43-3.99]. After adjusting for hormonal-related risk factors and family history of breast cancer (OR = 2.94, 95% CI 1.50-5.79) and also for the % BF (OR = 2.71, 95% CI 1.36-5.37) the odds remained high. Independent of the adjustments made, %BF did not affect the odds for developing BC. When the same models were tested for women with BBD, we found a significant association with sedentary lifestyle in all models tested, with an OR = 3.03 (95% CI 1.69-5.42) in the fully adjusted model. In the same way, in the fully adjusted model %BF was significantly associated to risk for BBD (OR = 0.54, 95% CI 0.30-0.98). Similar to results found in other populations, our data suggest that physical activity is an important, independent protective factor for the risk of developing BC and BBD in low-income women from an admixed population.
Assuntos
Neoplasias da Mama/epidemiologia , Doença da Mama Fibrocística/epidemiologia , Atividade Motora , Tecido Adiposo/metabolismo , Adulto , Idoso , Índice de Massa Corporal , Brasil , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Proteção , Fatores de Risco , Fatores Socioeconômicos , Circunferência da Cintura , Adulto JovemRESUMO
INTRODUCTION: There has been no previous study to classify benign breast lesions in details based on histopathologically confirmed diagnosis in Bayelsa State, Nigeria. This study therefore aims to review all cases of benign breast lesions seen in all the three centres in Bayelsa State with histopathology services over a five year period for a comprehensive baseline data in our community for management, research and education. METHODS: This is a multicentre retrospective descriptive study based on histopathological diagnosed benign breast lesions from January 2009 to December 2013. Archival results and slides on benign breast lesions were retrieved and analysed using simple statistical methods. RESULTS: A total of 228 benign breast lesions (68.3%) were seen among 334 histopathologically diagnosed breast diseases. The male to female ratio was 19.7:1. Peak age incidence was the third decade (43%) with a mean age of 29.1years. Fibroadenoma was the most common benign breast disease (BBD) accounting for 45.6% of all the cases followed by fibrocystic change (23.1%). The mean ages of fibroadenoma and fibrocystic change were 23.1years and 31.1years respectively. Inflammatory breast lesions constituted 8.3%. We recorded only 2 cases (0.9%) of atypical ductal hyperplasia (ADH) with no case of atypical lobular hyperplasia (ALH) within the study period. Gynaecomastia (4%) was the main male breast lesion in the study. CONCLUSION: Benign breast diseases are the most common breast lesions in Bayelsa State. Fibroadenoma is the most common lesion followed by fibrocystic change. The incidence of atypical hyperplasia recorded was rather low in the state.
Assuntos
Doenças Mamárias/epidemiologia , Doenças Mamárias/patologia , Adolescente , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/patologia , Feminino , Fibroadenoma/epidemiologia , Fibroadenoma/patologia , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Adult alcohol consumption during the previous year is related to breast cancer risk. Breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. No study has characterized the contribution of alcohol consumption during this interval to risks of proliferative benign breast disease (BBD) and breast cancer. METHODS: We used data from 91,005 parous women in the Nurses' Health Study II who had no cancer history, completed questions on early alcohol consumption in 1989, and were followed through June 30, 2009, to analyze breast cancer risk. A subset of 60,093 women who had no history of BBD or cancer in 1991 and were followed through June 30, 2001, were included in the analysis of proliferative BBD. Relative risks (RRs) were estimated using Cox proportional hazard regression. RESULTS: We identified 1609 breast cancer cases and 970 proliferative BBD cases confirmed by central histology review. Alcohol consumption between menarche and first pregnancy, adjusted for drinking after first pregnancy, was associated with risks of breast cancer (RR = 1.11 per 10 g/day intake; 95% confidence interval [CI] = 1.00 to 1.23) and proliferative BBD (RR = 1.16 per 10 g/day intake; 95% CI = 1.02 to 1.32). Drinking after first pregnancy had a similar risk for breast cancer (RR = 1.09 per 10 g/day intake; 95% CI = 0.96 to 1.23) but not for BBD. The association between drinking before first pregnancy and breast neoplasia appeared to be stronger with longer menarche to first pregnancy intervals. CONCLUSIONS: Alcohol consumption before first pregnancy was consistently associated with increased risks of proliferative BBD and breast cancer.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/etiologia , Menarca , Adolescente , Adulto , Distribuição por Idade , Idoso , Terapia de Reposição de Estrogênios , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Razão de Chances , Paridade , Pós-Menopausa , Gravidez , Modelos de Riscos Proporcionais , Estudos Prospectivos , História Reprodutiva , Medição de Risco , Fatores de Risco , Fatores de TempoRESUMO
BACKGROUND: Non-cancerous diseases of the breast have assumed increasing importance because of the public awareness of breast cancer. These benign diseases are a recognized important risk factor for later breast cancer which can develop in either breast. The risk estimate of these benign breast diseases has not been well established in sub Saharan Africa. Women with benign proliferative or atypical breast lesions have a two- fold risk of developing breast cancer in western populations. The purpose of this study therefore was to determine the prevalence of proliferative disease ( BPBD) with and without atypia among Ugandan Black women. METHODS: A cross-sectional descriptive study conducted at Mulago Hospital Breast Clinic between January 2012 and June 2012; 208 women aged 12 years and above with palpable breast lumps were screened. Fine needle aspiration biopsies were taken for cytological examination. RESULTS: Of the 208 women with benign breast lumps screened, 195 were recruited in the study. The prevalence of BPBD was 18% (35/195). BPBD with atypia was 5.6% (11/195). The mean age and body mass index (BMI) were 28.4 years and 23.26 kg/m2 respectively. The commonest lesions were fibroadenomas for 57%, (111/195), and fibrocystic change were 21% (40/195). Most BPBD with atypia lesions were in the fibrocystic category. CONCLUSIONS: Benign proliferative breast diseases are common, found mostly among premenopausal women. A significant proportion of BPBD had atypical proliferation. An accurate breast cancer risk estimate study for BPBD is recommended.
Assuntos
Doenças Mamárias/epidemiologia , Doenças Mamárias/patologia , Proliferação de Células , Adulto , População Negra , Doenças Mamárias/diagnóstico , Estudos Transversais , Feminino , Fibroadenoma/diagnóstico , Fibroadenoma/epidemiologia , Fibroadenoma/patologia , Doença da Mama Fibrocística/diagnóstico , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/patologia , Humanos , Risco , Centros de Atenção Terciária , Uganda/epidemiologiaRESUMO
BACKGROUND: The radiologic and pathologic characteristics of ductal carcinoma in situ (DCIS) that involves sclerosing adenosis (SA) (SA DCIS) resemble those of invasive carcinoma. However, differences in the clinical features of these conditions remain unclear. This study was designed to clarify the clinicopathologic characteristics of SA DCIS compared with those of DCIS not involving SA (non,-SA DCIS). METHODS: We retrospectively studied 1309 patients who underwent breast surgery at our hospital between January 2007 and December 2008. A total of 205 cases of DCIS were diagnosed in 198 patients, and 28 (13.7%) cases of breast SA DCIS were diagnosed in 24 patients. We compared clinical characteristics as well as radiologic and pathologic findings between SA DCIS and non-SA DCIS. RESULTS: Synchronous and metachronous bilateral breast cancer was detected at a significantly higher rate in SA DCIS (9 [38%] of 24 patients) than in non-SA DCIS (22 [13%] of 174 patients; P < .01). As for radiologic findings, architectural distortion was more frequent in patients with SA DCIS than in those with non-SA DCIS (15 [54%] of 28 cases vs. 5 [2%] of 177 cases on mammography; P < .01; and 14 [50%] of 28 cases vs. 4 [2%] of 177 cases on ultrasound; P < .01). The rate of negativity for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 was significantly higher in SA DCIS than in non-SA DCIS (5 [18%] of 28 cases vs. 5 [3%] of 177 cases, P = .005) with immunohistochemical studies. CONCLUSIONS: The rate of bilateral breast cancer and of architectural distortion on radiologic studies was higher in patients with SA DCIS than in those with non-SA DCIS. Our findings suggest that patients with SA DCIS should be closely monitored by radiologic and pathologic examinations to detect the presence of contralateral lesions.
Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Carcinoma Intraductal não Infiltrante/complicações , Carcinoma Intraductal não Infiltrante/epidemiologia , Doença da Mama Fibrocística/complicações , Doença da Mama Fibrocística/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/metabolismo , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Carcinoma Intraductal não Infiltrante/metabolismo , Estudos de Casos e Controles , Feminino , Doença da Mama Fibrocística/diagnóstico por imagem , Doença da Mama Fibrocística/metabolismo , Humanos , Incidência , Pessoa de Meia-Idade , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Ultrassonografia , Adulto JovemRESUMO
The article presents results obtained in study of relationship between polymorph variants of CYP1A1 and CYP1A2 genes with reproductive and thyroid diseases risk in female workers of petrochemical industry, when compared with reference group females. Variants TD and DD of CYP1A2 gene appeared to be associated with nodes formation in uterus and breast in female workers and reference group females. Following liability markers are obtained: homozygous in rare allele genotype CC of CYP1A1 gene for reproductive and thyroid diseaes (fibrous cystic mastopathy and nodular goitre), heterozygous genotype AG of CYP1A1 gene in uterine myoma and fibrous cystic mastopathy, homozygous in deleted T genotype of CYP1A2 gene in autoimmune thyroiditis. Occupational hazards and long length of service at hazardous industries increase effects of rare alleles of the genes studied.