Anatomic markers of human premalignancy and risk of breast cancer

Article Abstract:

The term premalignancy, akin to ''precancerous'', is used to refer to tissue abnormalities that are associated with an increased risk of subsequent development of cancer. However, an important distinction must be made. While some histopathological conditions may indicate an increased risk of cancer, it does not necessarily mean that the particular histological structure itself is the one that may turn into a cancer. Some findings are simply more likely in individuals with a greater predisposition to cancer. However, there are some histological lesions in which the lesion itself stands a high probability of undergoing cancerous transformation. Particularly with the advent of mammography, an increasing number of women are having biopsies on lesions that will turn out to be benign. Lesions such as adenosis, apocrine changes, and duct estasia carry no increased risk of breast cancer. While mild hyperplasia carries no increased risk, moderate or florid hyperplasia carries a risk of 1.5 to 2.0 times normal. The increased risk is defined as moderate when lesions such as atypical hyperplasia, either ductal or lobular, are observed. Moderate risk is defined as four to five times that of normal. It is worth noting that the presence of atypia interacts with other nonanatomic risk factors. Childbearing while still young decreases the risk of breast cancer; women who bear their first child in their teens have a risk of breast cancer of 0.8 times normal. In contrast, women who bear children in their 20s have a risk 1.3 times that of normal, and childless women have a risk factor of 1.6. These figures are more striking when women with atypia are considered: with age at first birth under 20, the risk is 1.6 times normal; with first birth over 20, the risk is 4.6; when childless, 4.9 times normal. A very serious risk of cancer is suffered by women with carcinoma in situ, whether lobular or ductal. The risk of breast cancer for these women is 8 to 10 times normal, and the carcinoma in situ itself appears to be the actual tissue that will become the cancer, and is thus literally ''precancerous''. Over 70 percent of all women with a negative breast biopsy have some condition that involves no increased risk of breast cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Breast

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Menopausal estrogen replacement therapy and breast cancer

Article Abstract:

Estrogen replacement therapy (ERT) is used to relieve the symptoms of menopause and to prevent osteoporosis (a bone disease) in postmenopausal women. Research suggests that ERT may also help protect against cardiovascular disease, which, beginning soon after menopause, affects women at the same rate as men. However, ERT increases the risk of endometrial (uterine lining) cancer, and may also increase the risk of breast cancer. The evidence indicates that the risk of breast cancer is related to the type and amount of estrogen given, and that low doses with conjugated estrogens do not increase the risk of breast cancer. A meta-analysis, which involves combining the results of many studies previously published in the literature, was done on this topic. The overall relative risk of breast cancer related to ERT was 1.07, averaged from all studies, but there was great variation in risk from one study to another. When the results were subdivided according to dosage, type of estrogen, and duration of treatment, it was found that a daily dosage of 1.25 milligrams (mg) or more of conjugated estrogens may increase the risk of breast cancer by up to a factor of two, but the studies varied greatly on the relative risk. The meta-analysis yielded strong evidence that a daily dosage of 0.625 mg or less of conjugated estrogens does not increase the risk of breast cancer, even when administered for a long time. At this lower dosage it appears that ERT can also be taken by women with a history of benign (noncancerous) breast disease without increasing the risk of breast cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Usage, Drug therapy, Menopause, Estrogen, Estrogens, Meta-analysis

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Invasive breast cancer risk in women with sclerosing adenosis

Article Abstract:

Sclerosing adenosis (SA) are benign lesions in gland tissues that are often mistaken for metastatic cancer because of a similar appearance. A study was conducted to see if SA is an independent risk factor for invasive breast cancer (IBC), as there have been conflicting reports of an association between the two conditions. Of the 10,366 benign breast samples examined, 547 cases of SA were identified. SA occurred primarily in women from age 21 to age 50, with the peak incidence in women who were 41 to 50 years old. There was a sharp decline in the incidence in postmenopausal women who were 50 years or older. Patients with SA had 2.1 times the incidence of IBC compared with the general population. When patients with atypical hyperplasia or proliferation of cells in the breast tissue were not included in the analysis, the risk was decreased to 1.7 times. Patients with atypical hyperplasia had 4.4 times the risk of developing IBC. Women who had both SA and atypical hyperplasia had seven times the relative risk of developing IBC when compared with the general population. There was a small but significant increased incidence (15.3 percent) of family history of breast cancer in patients with SA compared with those without SA (10.7 percent). It was concluded that SA should be described as a proliferative disease that is associated with a 1.5 to 2 times increased risk for invasive breast cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Case studies, Complications and side effects, Cancer, Pathology, Cellular, Cytopathology, Hyperplasia

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