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Benign breast disease, family history studied

Posted on: Wednesday, 20 July 2005, 16:45 CDT

By Gene Emery

BOSTON (Reuters) - Women diagnosed with benign breast disease but who do not have a strong family history of breast cancer have no heightened risk of developing a tumor, according to a new study.

"If women do not have a strong family history, the risk does not increase," said Lynn Hartmann, chief author of the report, which appears in Thursday's New England Journal of Medicine.

"Most of what we're putting out there, I would put in the 'good news' category," Hartmann, an oncologist at the Mayo Clinic, added.

Doctors have long known changes in the breast are often a harbinger of cancer. Hartmann's study looked at 9,087 women with benign breast disease for an average of 15 years to quantify those risks.

Among women with cysts, also known as nonproliferative disease, researchers found the breast cancer risk was 27 percent higher than expected.

That was the most common type of benign disease found in 67 percent of the women in the study, and 1 million women in the United States are diagnosed with such disease every year.

For every 100 women with nonproliferative disease, about six will develop breast cancer, compared with five cases in 100 expected over the 15-year period among women in the general population.

A cyst occurs when a breast duct becomes enlarged and filled with fluid, and the tissue around the duct thickens because it contains too much collagen.

In cases of atypical hyperplasia, where cells of the breast look too large, too abundant and abnormal under the microscope -- but not abnormal enough to be cancerous -- the risk of breast cancer quadruples.

In that case, 19 out of 100 of those women are likely to develop a tumor over the next 15 years.

But only 4 percent of women with some type of benign breast disease fall into that category. Hartmann told Reuters that earlier estimates set the risk much higher -- perhaps eight to 10 times higher among women with a family history of breast cancer. "We don't see that," she said.

Those women, especially younger women, may be candidates for taking drugs like tamoxifen, which is designed to prevent breast cancer, or having their breasts checked using MRIs instead of conventional mammography.

"You need to make sure the surveillance is the best it can be," she said.

In intermediate cases, representing about 30 percent of the women in the study, the cells seem to be growing a little too rapidly, but they still look normal.

Among those women, the risk of breast cancer was twice what would normally be expected, or 10 women out of 100 during the 15-year period.

Age plays an important role in the risk. Women diagnosed with atypical hyperplasia under the age of 45 face twice the risk of cancer than women found to have hyperplasia at age 56 and over.

Source: REUTERS

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