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Clinical and histologic characteristics of breast cancers in women with previous pathologic diagnosis of benign breast disease in Spain
Authors:Marta Román PhD  Martin Caicoya MD  Josep Espinàs PhD  Maria Sala PhD  Isabel Torá‐Rocamora PhD  Maria J. Quinta PhD  Mar Vernet PhD  Francina Saladié MD  Anabel Romero PhD  Mar Sánchez MD  Marisa Baré PhD  Carmen Vidal MPH  S. Servitja MD  Carmen Natal PhD  Joosep Corominas MD  Joana Ferrer MD  Ana Rodríguez‐Arana MD  Xavier Castells PhD  the BELE Project study group
Affiliation:1. Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain;2. Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain;3. Department of Health, Catalan Cancer Plan, Barcelona, Spain;4. Preventive Medicine and Epidemiology Department, Hospital Clinic, Barcelona, Spain;5. Epidemiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;6. Department of Obstetrics and Gynecology, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain;7. Breast Cancer Screening Program of Tarragona, The Foundation League for the Research and Prevention of Cancer, Tarragona, Spain;8. General Directorate of Public Health, Government of Cantabria, Santander, Spain;9. Clinical Epidemiology and Cancer Screening, Parc Taulí University Hospital, Sabadell, Spain;10. Cancer Prevention and Monitoring Program, Catalan Institute of Oncology, Barcelona, Spain;11. Department of Oncology, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain;12. Breast Cancer Screening Program, Principality of Asturias, Oviedo, Spain;13. Department of Pathological Anatomy, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain;14. Radiology Department, Hospital de Santa Caterina, Girona, Spain;15. Department of Image Diagnostics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Abstract:Women with a benign breast disease (BBD) have an increased risk of subsequent breast carcinoma. Information is scarce regarding the characteristics of breast carcinomas diagnosed after a BBD. Our aim was to point out the differences in clinical and histologic characteristics of breast carcinomas diagnosed in women with and without a previous pathologic diagnosis of BBD in the context of population‐based mammography screening. Retrospective cohort study of all women aged 50‐69 years who were screened at least once in a population‐based screening program in Spain, between 1994 and 2011 and followed up until December 2012. The mean follow‐up was 6.1 years. We analyzed 6645 breast carcinomas, of whom 238 had a previous pathologic diagnosis of BBD. Information on clinical and histologic characteristics was collected from pathology reports. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (95%CI) of occurrence of selected histologic characteristics of breast carcinomas in women with and without a previous BBD. Women with a previous BBD had a higher proportion of ductal carcinoma in situ (DCIS) compared with women without a BBD (22.1% and 13.6%, respectively). Among those diagnosed with an invasive breast carcinoma, women with previous BBD were more likely to be diagnosed with carcinomas sized >2 cm (OR = 1.46; 95%CI = 1.03‐2.08), metastatic positive (OR = 2.66; 95%CI = 1.21‐5.86), and with a high Ki‐67 proliferation rate (OR = 1.93; 95%CI = 1.24‐2.99). No differences were found across histologic subtypes of BBD. Screening participants with a previous pathologic diagnosis of BBD had a higher proportion of DCIS. However, invasive carcinomas detected in women with a BBD were associated with clinical and histologic characteristics conferring a worst prognosis.
Keywords:benign breast disease  breast neoplasm  prognostic factors
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