The influence of family history on breast cancer risk in women with biopsy-confirmed benign breast disease

Results from the Nurses' Health Study

Authors

  • Laura C. Collins MD,

    Corresponding author
    1. Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
    • Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215
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    • Fax: (617) 667 7120.

  • Heather J. Baer ScD,

    1. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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  • Rulla M. Tamimi ScD,

    1. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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  • James L. Connolly MD,

    1. Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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  • Graham A. Colditz MD, DrPh,

    1. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    2. Harvard Center for Cancer Prevention, Boston, Massachusetts
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  • Stuart J. Schnitt MD

    1. Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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Abstract

BACKGROUND

An association between histologic category of benign breast disease (BBD) and breast cancer risk has been well documented. However, the influence of a positive family history (FH) on breast cancer risk among women with biopsy-confirmed BBD is less certain.

METHODS

The authors conducted a nested case–control study of BBD and breast cancer risk among 2005 women who were enrolled in the Nurses' Health Study. Cases were women with breast cancer who had a previous benign breast biopsy (n = 395 women). Controls were women who also had previous biopsy-confirmed BBD but were free from breast cancer at the time the corresponding case was diagnosed (n = 1610 women). BBD slides were reviewed and categorized as either nonproliferative lesions, proliferative lesions without atypia, or atypical hyperplasia (AH).

RESULTS

Compared with women who had nonproliferative lesions and no FH, women who had proliferative lesions without atypia and a positive FH had a higher breast cancer risk (odds ratio [OR], 2.45; 95% confidence interval [95% CI], 1.61–3.70) than women with no FH (OR, 1.51; 95% CI, 1.12–2.06; P = .07). Among women who had AH, the OR for the development of breast cancer was 4.38 (95% CI, 2.93–6.55) for those with no FH and 5.37 (95% CI, 3.01–9.58) for those with a positive FH (P = .57). There was no significant interaction between the type of BBD and FH (P = .74).

CONCLUSIONS

A positive FH of breast cancer slightly increased the breast cancer risk among women who had proliferative lesions without atypia. The increase in risk of breast cancer associated with FH was not significant among women who had AH. Cancer 2006. © 2006 American Cancer Society.

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