4 The presence of proliferative breast disease with atypia does not influence outcome in invasive breast cancer treated with conservative surgery and radiation

9602 Background: While survival rates for patients diagnosed with invasive breast cancer have increased dramatically, survivors often face a host of adverse health effects. Factors such as obesity, physical activity and tobacco may contribute to decreased survival and quality of life. Here, we evaluated behavioral risk factors in patients with and without breast cancer to determine whether a diagnosis of invasive disease was sufficient motivation to modify lifestyle choices. Methods: The dataset included patients undergoing surgical procedures between 2001 and 2006 and diagnosed with malignant (n=299) or benign (n=130) breast disease and who had baseline and 1-year follow-up information available. Changes in BMI, fat intake, exercise frequency, alcohol and tobacco use, caffeine consumption and frequency of breast self exam (BSE) were assessed. Results: At baseline (diagnosis), significantly more (P<0.005) invasive patients (70%) were menopausal compared to benign patients (48%), no other patient characteristics were significantly different between malignant and benign groups at baseline; a majority in both groups were overweight, non (current) smokers, and consumed high fat diets, ∼40% reported exercising >3 times/week, >60% had high (>500 mg/day) levels of caffeine and consumed low (<1 drink/month) levels of alcohol. The only modifiable behavior that showed a significant change (P<0.05) between baseline and 1-year from diagnosis was compliance with recommended BSE frequency in invasive patients, improving from 61% of patients at baseline to 72% one year later; a concomitant change was not seen in benign patients. No other behaviors changed either from baseline to 1-year or between invasive and benign patients. Conclusions: The paucity of behavioral changes after a diagnosis of breast cancer suggests that a diagnosis of breast cancer is not sufficient motivation to promote healthier lifestyles. Our data suggest a need for increased health-related behavioral counseling and support systems to successfully modify personal behaviors. Development and implementation of lifestyle recommendations have the potential to improve the health and quality of life of breast cancer survivors. No significant financial relationships to disclose.

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Relation of Quantitative Histologic and Radiologic Breast Tissue Composition Metrics with Invasive Breast Cancer Risk

10.1101/2020.11.12.20230623 ◽

2020 ◽

Author(s):

Mustapha Abubakar ◽

Shaoqi Fan ◽

Erin Aiello Bowles ◽

Lea Widemann ◽

Máire A. Duggan ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Invasive Breast Cancer ◽

Predictive Biomarkers ◽

Breast Cancer Diagnosis ◽

Breast Cancer Risk Factor ◽

Breast Disease ◽

Computer Assisted ◽

Tissue Composition

AbstractPurposeBenign breast disease (BBD) is a strong breast cancer risk factor but identifying patients that might develop invasive breast cancer remains a challenge.MethodsBy applying machine-learning to digitized H&E-stained biopsies and computer-assisted thresholding to mammograms obtained circa BBD diagnosis, we generated quantitative tissue composition metrics and determined their association with future invasive breast cancer diagnosis. Archival breast biopsies and mammograms were obtained for women (18-86 years) in a case-control study, nested within a cohort of 15,395 BBD patients from Kaiser Permanente Northwest (1970-2012), followed through mid-2015. Cases (n=514) who developed incident invasive breast cancer and controls (n=514) were matched on BBD diagnosis age and plan membership duration.ResultsIncreasing epithelial area on the BBD biopsy was associated with increasing breast cancer risk [Odds ratio(OR) 95% confidence interval(CI) Q4 vs Q1=1.85(1.13-3.04);Ptrend=0.02]. Conversely, increasing stroma was associated with decreased risk in non-proliferative, but not proliferative, BBD (Pheterogeneity=0.002). Increasing epithelium-to-stroma proportion [OR(95%CI)Q4 vs Q1=2.06(1.28-3.33);Ptrend=0.002] and percent mammographic density (MBD) [OR(95%CI)Q4 vs Q1=2.20(1.20-4.03);Ptrend=0.01] were independently and strongly predictive of increased breast cancer risk. In combination, women with high epithelium-to-stroma proportion/high MBD had substantially higher risk than those with low epithelium-to-stroma proportion/low MBD [OR(95%CI)=2.27(1.27-4.06);Ptrend=0.005], particularly among women with non-proliferative [Ptrend=0.01] versus proliferative [Ptrend=0.33] BBD.ConclusionAmong BBD patients, increasing epithelium-to-stroma proportion on BBD biopsies and percent MBD at BBD diagnosis were independently and jointly associated with increasing breast cancer risk. These findings were particularly striking for women with non-proliferative disease (comprising ∼70% of all BBD patients), for whom relevant predictive biomarkers are lacking.

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Somatic Genetic Aberrations in Benign Breast Disease and the Risk of Subsequent Breast Cancer

10.1101/613505 ◽

2019 ◽

Cited By ~ 1

Author(s):

Zexian Zeng ◽

Andy Vo ◽

Xiaoyu Li ◽

Ali Shidfar ◽

Paulette Saldana ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Risk ◽

Invasive Breast Cancer ◽

Benign Breast Disease ◽

Breast Disease ◽

Genetic Alterations ◽

Benign Lesions ◽

Genetic Aberrations ◽

Established Risk Factor ◽

Number Variation

AbstractIt is largely unknown how the risk of development of breast cancer is transduced by somatic genetic alterations. To address this lacuna of knowledge and acknowledging that benign breast disease (BBD) is an established risk factor for breast cancer, we established a case-control study: The Benign Breast & Cancer Risk (BBCAR) Study. Cases are women with BBD who developed subsequent invasive breast cancer (IBC) at least 3 years after the biopsy and controls are women with BBD who did not develop IBC (median follow-up 16.6 years). We selected 135 cases and individually matched controls (1:2) to cases based on age and type of benign disease: non-proliferative or proliferation without atypia. Whole exome sequencing was performed on DNA from the benign lesions and from subsets with available germline DNA or tumor DNA. Although the number of cases and controls with copy number variation data is limited, several amplifications and deletions are exclusive to the cases. In addition to two known mutational signatures, a novel signature was identified that is significantly (p=0.007) associated with triple negative breast cancer. The somatic mutation rate in benign lesions is similar to that of invasive breast cancer and does not differ between cases and controls. Two mutated genes are significantly associated with time to the diagnosis of breast cancer, and mutations shared between the benign biopsy tissue and the breast malignancy for the ten cases for which we had matched pairs were identified. BBD tissue is a rich source of clues to breast oncogenesis.One Sentence SummaryGenetic aberrations in benign breast lesions distinguish breast cancer cases from controls and predict cancer risk.

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Pathologic Factors Predictive of Local Recurrence in Patients with Invasive Breast Cancer Treated by Conservative Surgery and Radiation Therapy

Non-Disseminated Breast Cancer - Medical Radiology ◽

10.1007/978-3-642-84593-2_10 ◽

1993 ◽

pp. 93-104 ◽

Cited By ~ 5

Author(s):

Stuart J. Schnitt

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Local Recurrence ◽

Invasive Breast Cancer ◽

Conservative Surgery

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Infiltrating immune cells in benign breast disease and risk of subsequent invasive breast cancer

Breast Cancer Research ◽

10.1186/s13058-021-01395-x ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Thomas E. Rohan ◽

Rhonda Arthur ◽

Yihong Wang ◽

Sheila Weinmann ◽

Mindy Ginsberg ◽

...

Keyword(s):

Breast Cancer ◽

Immune Response ◽

Invasive Breast Cancer ◽

Normal Tissue ◽

Benign Breast Disease ◽

Immune Cell ◽

Menopausal Status ◽

Lymphocytic Infiltration ◽

Breast Disease ◽

Cell Counts

Abstract Background It is well established that tumors are antigenic and can induce an immune response by the host, entailing lymphocytic infiltration of the tumor and surrounding stroma. The extent and composition of the immune response to the tumor, assessed through evaluation of tumor-infiltrating lymphocyte counts, has been shown in many studies to have prognostic and predictive value for invasive breast cancer, but currently, there is little evidence regarding the association between infiltrating immune cell counts (IICCs) in women with benign breast disease (BBD) and risk of subsequent invasive breast cancer. Methods Using a cohort of 15,395 women biopsied for BBD at Kaiser Permanente Northwest, we conducted a nested case-control study in which cases were women who developed a subsequent invasive breast cancer during follow-up and controls were individually matched to cases on age at BBD diagnosis. We assessed IICCs in normal tissue and in the BBD lesions, and we used unconditional logistic regression to estimate the multivariable odds ratios (OR) and 95% confidence intervals (CI) for the associations between IICCs and breast cancer risk. Results There was no association between the IICC in normal tissue (multivariable OR per 5% increase in IICC = 1.05, 95% CI = 0.96–1.16) or in the BBD lesion (OR per 5% increase in IICC = 1.06, 95% CI = 0.96–1.18) and risk of subsequent invasive breast cancer. Also, there were no associations within subgroups defined by menopausal status, BBD histology, BMI, and history of smoking. Conclusion The results of this study suggest that IICCs in BBD tissue are not associated with altered risk of subsequent invasive breast cancer.

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