RESUMO
BACKGROUND: As women age, the lobules in their breasts undergo involution or regression. We investigated whether lobular involution in women with benign breast disease was associated with subsequent breast cancer risk. METHODS: We examined biopsy specimens of 8736 women in the Mayo Benign Breast Disease Cohort from whom biopsy samples were taken between January 1, 1967, and December 31, 1991. Median follow-up for breast cancer outcomes was 17 years. We classified lobular involution in the background breast tissue as none (0% involuted lobules), partial (1%-74%), or complete (> or = 75%). Subsequent breast cancer events and data on other risk factors were obtained from medical records and follow-up questionnaires. To estimate relative risks (RRs), standardized incidence ratios were calculated by use of incidence rates from the Iowa Surveillance, Epidemiology, and End Results (SEER) Registry. All statistical tests were two-sided. RESULTS: Distribution of extent of involution was none among 1627 (18.6%) women, partial among 5197 (59.5%), and complete among 1912 (21.9%). Increased involution was positively associated with increased age and inversely associated with parity (both P<.001). The relative risk for the entire cohort of 8736 women, compared with the Iowa SEER population, was 1.40 (95% CI = 1.30 to 1.51). Risk of breast cancer was associated with the extent of involution (for no involution, RR [i.e., observed versus expected] = 1.88, 95% confidence interval [CI] = 1.59 to 2.21; for partial involution, RR = 1.47, 95% CI = 1.33 to 1.61; and for complete involution, RR = 0.91, 95% CI = 0.75 to 1.10; test for heterogeneity P<.001). Lobular involution modified risk in all subsets (e.g., among women with atypia, for no involution, RR = 7.79, 95% CI = 3.56 to 14.81; for partial involution, RR = 4.06, 95% CI = 3.03 to 5.33; and for complete involution, RR = 1.49, 95% CI = 0.41 to 3.82; P = .003). CONCLUSIONS: In this large cohort of women with benign breast disease, lobular involution was associated with reduced risk of breast cancer. Aberrant involution may be a biologically important phenomenon in breast cancer biology.
Assuntos
Envelhecimento , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/prevenção & controle , Mama/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Mama/anatomia & histologia , Neoplasias da Mama/patologia , Neoplasias da Mama/fisiopatologia , Carcinoma Lobular/epidemiologia , Carcinoma Lobular/prevenção & controle , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Iowa/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Medição de Risco , Fatores de Risco , Programa de SEERRESUMO
A perusal of the literature reveals the many ways quilt design and personal communication is interwoven. We selected quilt making to provide those affected by breast cancer-as a patient, friend or relative-the opportunity to communicate their experience through quilt making. With the participation of community quilters, a concept and quilt design was developed to incorporate the work of patients and others in making a quilt. The project pattern and materials were presented. Contributors were invited to write about what inspired them to participate. For the 80 blocks that were constructed as twin quilts, 36 individuals wrote something about their block. Analysis of the vignettes identified major categories. The most common theme was honoring a specific person's life and their breast cancer journey. Displayed together with their accompanying vignettes, the quilts have become a focal point for interaction among patients and their families.