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- Title
Age-Related Lobular Involution and Risk of Breast Cancer.
- Authors
Milanese, Tia R.; Hartmann, Lynn C.; Sellers, Thomas A.; Frost, Marlene H.; Vierkant, Robert A.; Maloney, Shaun D.; Pankratz, V. Shane; Degnim, Amy C.; Vachon, Celine M.; Reynolds, Carol A.; Thompson, Romayne A.; Melton III, L. Joseph; Goode, Ellen L.; Visscher, Daniel W.
- Abstract
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 (≥=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.
- Subjects
BREAST cancer; CANCER risk factors; MEDICAL records; CANCER in women; BIOPSY; CANCER
- Publication
JNCI: Journal of the National Cancer Institute, 2006, Vol 98, Issue 22, p1600
- ISSN
0027-8874
- Publication type
Article
- DOI
10.1093/jnci/djj439