Extra-tumoral breast tissue in breast cancer patients: Variations with steroid contraceptive use

Authors

  • Tone B. Aaman Vamre,

    Corresponding author
    1. Institute of Medical Biology, University of Tromsø, Norway
    • Institute of Medical Biology, University of Tromsø, N-9037 Tromsø, Norway
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    • Fax: +47-22119899

  • Helge Stalsberg,

    1. Institute of Medical Biology, University of Tromsø, Norway
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  • David B. Thomas,

    1. Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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  • The WHO Collaborative Study of Neoplasia and Steroid Contraceptives

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    • The data collection centers and the principal investigator (PI), co-investigator (CI) and pathologist (P) at each participating center in alphabetical order by country are as follows: Department of Public Health, University of Sydney, Sydney, Australia: G. Berry (PI), R. Maclennan (CI), R. Shearman (CI), T. Jelihovsky (P), J. Cooper Booth (P); Department of Obstetrics and Gynecology, Faculty of Medicine, Hospital Jose Joaquin Aguirre, University of Chile, and the Department of Obstetrics and Gynecology, Hospital Salvador, Ministry of Health, Santiago, Chile: R. Molina (PI), L. Martinez (CI), O. Salas (CI), A. Dabacens (P); Shanghai Institute of Planned Parenthood Research, Shanghai, China: Cheng Zhiheng (PI), Tao Yun (CI), Hu Yong Wei (P); Hospital Universitario, WHO Collaborative Center for Research in Human Reproduction, Cali, Colombia: A. Cuadros (PI), N. Aristizabal (P); Central Institute of Cancer Research, Academy of Sciences of the German Democratic Republic, Berlin, GDR: K. Ebeling (PI), P. Nishan (CI), D. Kunde (P); Department of Clinical Epidemiology, Chaim Sheba Medical Center, Tel Hashomer, Israel: B. Modan (PI), E. Ron (CI), E. Alfandary (CI); University of Nairobi, Nairobi Center for Research in Reproduction, Nairobi, Kenya: J. G. Mati (PI), P. Kenya (CI), A. Kungu (P), D. Gatei (P); Hospital General de Mexico, Mexico City, Mexico: H. Rodriguez Cuevas (PI), S. Benavides Salazar (CI), A. Palet (P), P. Ontiveros (P); College of Medicine, University of Philippines, Manila, The Philippines: R. A. Apelo (PI), J. R. De La Cruz (CI), J. Baens (CI), B. Javier (P); Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand: Suporn Silpisornkosol (PI), Tieng Pardthaisong (CI), Nimit Martin (CI), Choti Theetranont (P); Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, WHO Collaborating Center for Research in Human Reproduction, Bangkok, Thailand: Banpot Boosiri (PI), Supawat Chutivongse (PI), Pramuan Virutamasen (CI), Chansuda Wongsrichanalai (C), Prasarn Jimakorn (P); Department of Obstetrics and Gynecology, Family Planning Research Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand: Suporn Koetsawang (PI), Daungdao Rachawat (CI), Nivat Chantarakul (P); Fred Hutchinson Cancer Research Center, Seattle, WA, USA: R. M. Ray (CI), E. A. Noonan (CI); World Health Organization: S. Holck, Special Programme of Research Development and Research Training in Human Reproduction, Geneva, Switzerland.


Abstract

The association between oral contraceptive (OC) use and benign breast changes in extra-tumoral breast tissue was studied histologically in 1,503 breast cancer patients from The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. The occurrence of ductal hyperplasia, ductal atypia, sclerosing adenosis, cysts, apocrine metaplasia, apocrine hyperplasia, apocrine atypia, adenosis, lobular atypia, duct ectasia, calcifications, inflammatory reaction, lactational metaplasia and a high epithelial-stromal ratio was graded semi-quantitatively. Prevalence odds ratio (POR) for each histologic variable was calculated by logistic regression analyses. Patients who had ever used OC had lower occurrence of ductal hyperplasia than never users (POR 0.72 (95% CI 0.52–0.99)). Current use and more than 8 years of use was also associated with a lower prevalence of ductal hyperplasia (POR 0.40 (0.20–0.81) and POR 0.33 (0.17–0.64), respectively). Age > 35 years at first use was associated with increased prevalence of ductal carcinoma in situ (POR 2.15 (1.05–4.40)), but not of atypical ductal hyperplasia. Our results show that the effects of OC use on ductal hyperplasia in non-neoplastic breast tissue of breast cancer patients are similar to what others have found in patients with benign breast disease only. The increased prevalence of extra-tumoral ductal carcinoma in situ in breast cancer patients who started OC use at high age may possibly be explained by a longer preinvasive phase in these patients. © 2005 Wiley-Liss, Inc.

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