Personal history of atypical ductal hyperplasia and risk of multifocal breast cancer among newly diagnosed women: Implications for workup and management.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 300-300
Author(s):  
Curtis Lee Petersen ◽  
Tracy Onega
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Atypical Ductal Hyperplasia ◽  
Newly Diagnosed ◽  
Multifocal Breast Cancer ◽  
Ductal Hyperplasia ◽  
Significant Difference ◽  
History Of ◽  
In Situ Breast Cancer

300 Background: Multifocal breast cancer (MFBC) is associated with a higher risk of mortality than unifocal and often changes evaluation and management compared to unifocal breast cancer. Although there are known risk factors for invasive breast cancer, including atypical ductal hyperplasia (ADH), none have been explicitly associated with risk of MFBC. Our objective was to determine if there is an association between ADH and MFBC to help guide clinical decisions in workup and management in women with newly-diagnosed breast cancer. Methods: Using data (1999-2008) from the New Hampshire Mammography Network (NHMN) – a longitudinal breast imaging registry, including pathology data – we identified a cohort of 3,039 women (median age: 59) with a diagnosis of invasive or in situ breast cancer, and ascertained all prior biopsy results if applicable. We performed multivariable logistic regression to test the association of ADH with MFBC v. unifocal, adjusting for other benign breast disease, family history, breast density, age, race, and DCIS/invasive. Results: Of the 3,039 women with breast cancer during the study period, 498 had a diagnosis of ADH (16.4%) and 277 had MFBC (9.1%). Women with a history of ADH had over a two-fold greater likelihood of having MFBC compared to women without an ADH diagnosis (OR: 2.20, 95% CI: 1.61-2.99). No notable difference in this association was noted for DCIS v. invasive, and no other risk factors were found to have a significant difference, except for number of biopsies. Conclusions: We found that ADH diagnosis is positively associated with MFBC among women with a diagnosed invasive or in situ breast cancer. Our results suggest that among women with a newly diagnosed breast cancer, history of an ADH diagnosis increases the pre-test probability of MFBC, which may influence evaluation of extent of disease, such as adding breast MRI, and ultimately in treatment and management.

scholarly journals Risk factors for young-onset invasive and in situ breast cancer

2015 ◽  
Vol 26 (12) ◽  
pp. 1771-1778 ◽  
Author(s):  
Katie M. O’Brien ◽  
Jenny Sun ◽  
Dale P. Sandler ◽  
Lisa A. DeRoo ◽  
Clarice R. Weinberg
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Young Onset ◽  
In Situ Breast Cancer

Breast cancer events in women with atypical ductal hyperplasia who do not undergo surgical excision.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1562-1562
Author(s):  
Lyndsey Jo Kilgore ◽  
Min Yi ◽  
Therese Bartholomew Bevers ◽  
Robin Coyne ◽  
Marita Lazzaro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Risk ◽  
Needle Biopsy ◽  
Atypical Ductal Hyperplasia ◽  
Surgical Excision ◽  
Cancer History ◽  
Ductal Hyperplasia ◽  
Index Site ◽  
History Of

1562 Background: Atypical ductal hyperplasia (ADH) found on core needle biopsy is associated with an upgrade to carcinoma in 10-30% of women, thus surgical excision remains the standard of care. We sought to review the incidence of breast cancer in women with ADH managed by either observation or surgical excision over a 15 year period. Methods: Our prospectively maintained registry was reviewed to identify patients with ADH diagnosed by core needle biopsy between 1/2004 and 10/2018. Observed patients were deemed low risk for upgrade after multidisciplinary review confirmed adequate sampling, limited atypia and concordance between imaging and histology. Surgical patients were excluded if upstaged to carcinoma following excision. Patients with < 1 year follow-up were excluded. Subsequent breast cancer was classified as ipsilateral or contralateral to the previous ADH and was further classified as index site if the new cancer was identified in the same quadrant as prior ADH. Multivariate logistic regression models were used to assess potential predictors of subsequent breast cancer events. Results: Four hundred and seventy-eight women with 483 ADH lesions met criteria; 305 were observed and 173 underwent excision. Median follow-up was 5.2 years, range 1.1-15.3. At the time of ADH diagnosis, 91 women had a personal history of breast cancer. Age < 50 was the only statistically significant difference between the groups (24.6% vs. 33.3%, p = 0.04). Race, receipt of chemoprevention, prior breast cancer history and median follow-up were not significant between the groups. Prior history of breast cancer was associated with subsequent breast cancer risk in multivariate analysis (OR 2.25, 95% CI 1.04-4.87, p = 0.04). After excluding patients with a history of breast cancer, multivariate analysis demonstrated no association of age, race, use of chemoprevention or surgical excision with future cancer risk. Among the 387 patients without a prior breast cancer history, 21 patients developed a subsequent cancer; 10 in the surgical group and 11 in the observed group (7.3% vs. 4.4% respectively, p = 0.2). Two cancers were identified at the index site in the surgery group (2/137, 1.5%) and three in those observed (3/250, 1.2%). Conclusions: Observation, rather than surgical excision, is safe in selected women that have a core biopsy diagnosis of ADH. Index site failures are rare and are superseded by cancer risk elsewhere in the breast. National screening and diagnosis recommendations should consider recommending observation for this select group of patients with ADH.

scholarly journals Natural History of In Situ Breast Cancer in a Defined Population

1989 ◽  
Vol 210 (5) ◽  
pp. 653-657 ◽  
Author(s):  
WALLEY J. TEMPLE ◽  
MARILYN JENKINS ◽  
FRED ALEXANDER ◽  
WEI-SEK HWANG ◽  
LENNART H. MARX ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Natural History ◽  
History Of ◽  
In Situ Breast Cancer

scholarly journals Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1120
Author(s):  
Luca Nicosia ◽  
Antuono Latronico ◽  
Francesca Addante ◽  
Rossella De Santis ◽  
Anna Carla Bozzini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Carcinoma ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Atypical Ductal Hyperplasia ◽  
Univariate Analysis ◽  
Surgical Excision ◽  
P Value ◽  
Ductal Hyperplasia

(1) Background: to evaluate which factors can reduce the upgrade rate of atypical ductal hyperplasia (ADH) to in situ or invasive carcinoma in patients who underwent vacuum-assisted breast biopsy (VABB) and subsequent surgical excision. (2) Methods: 2955 VABBs were reviewed; 141 patients with a diagnosis of ADH were selected for subsequent surgical excision. The association between patients’ characteristics and the upgrade rate to breast cancer was evaluated in both univariate and multivariate analyses. (3) Results: the upgrade rates to ductal carcinoma in situ (DCIS) and invasive carcinoma (IC) were, respectively, 29.1% and 7.8%. The pooled upgrade rate to DCIS or IC was statistically lower at univariate analysis, considering the following parameters: complete removal of the lesion (p-value < 0.001); BIRADS ≤ 4a (p-value < 0.001); size of the lesion ≤15 mm (p-value: 0.002); age of the patients <50 years (p-value: 0.035). (4) Conclusions: the overall upgrade rate of ADH to DCIS or IC is high and, as already known, surgery should be recommended. However, ADH cases should always be discussed in multidisciplinary meetings: some parameters appear to be related to a lower upgrade rate. Patients presenting these parameters could be strictly followed up to avoid overtreatment.

Abstract A71: Risk factors for in situ breast cancer among postmenopausal women

2011 ◽  
Author(s):  
Cher M. Dallal ◽  
Sarah J. Nyante ◽  
Gretchen L. Gierach ◽  
Mark E. Sherman ◽  
Yikyung Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Postmenopausal Women ◽  
In Situ Breast Cancer

scholarly journals Reproductive risk factors and breast cancer: a case control study from rural India

2015 ◽  
Vol 14 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Vaishali R Mohite ◽  
Asha K Pratinidhi ◽  
Rajsinh Vishwasrao Mohite
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Feeding ◽  
Menopausal Status ◽  
Hormonal Contraceptives ◽  
Reproductive Risk ◽  
History Of ◽  
Reproductive Risk Factors ◽  
Post Menopausal ◽  
Strength Of Association

Background: Breast cancer is the most common type of cancer in women and is influenced by reproductive factors perceived by women worldwide.Aims: To identify the reproductive risk factors of breast cancer in newly diagnosed cases and to find out the strength of association of the risk factors with the breast cancer. Material and Methods: A hospital based case-control study was conducted in Satara district, India during year 2009 to 2011 among newly diagnosed cases of breast cancer and matched controls. A total of 434 participants including 217 cases and 217 controls were enrolled by purposive sampling technique from selected hospitals of study area. The information was collected by employing pre-tested questionnaire by utilizing interview method. Statistical Analysis used: Descriptive statistics, Odds ratio and Chi-square test was used to find out strength of association and statistical significant difference. Results: Highest proportion [31.80%] breast cancer cases was in age group 40-49 years with lowest age of 25 years at diagnosis of the disease. A very high proportion of both cases [88.02%] and controls [67.28%] were Hindu by religion and were from rural residence. Maximum proportion of breast cancer cases were housewives [63.59%], literate [71.42%] and from upper economic class [56.68%]. The proportions of cases were higher as compared to the controls with respect to risk factors like unmarried status, nulliparity, history of abortion, post menopausal status, absence of breast feeding and the history of exposure to hormonal contraceptives. The risk of getting breast cancer as indicated by Odds ratio was 8 times higher in unmarried women, 2.8 times in nulliparous women, 2.4 times with post menopausal status, 10.4 times with absence of breast feeding, 1.5 times with exposure to hormonal contraceptives and 4.5 times with history of ovarian disease respectively. Conclusion: The reproductive risk factors such as unmarried status of women, nulliparity, menopause, absence of breast feeding, history of ovarian disease and use of contraceptives were strongly associated with breast cancer.Bangladesh Journal of Medical Science Vol.14(3) 2015 p.258-264

scholarly journals The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

2020 ◽  
Author(s):  
Ruifang Liu ◽  
Fangxing Xu ◽  
Yujie Zhou ◽  
Tongku Liu
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Young Women ◽  
Early Onset ◽  
Young Female ◽  
Cardiac Insufficiency ◽  
Control Group ◽  
Significant Difference ◽  
Gynecological Diseases ◽  
History Of

Abstract Background In recent years, the prevalence rate of ACS in Chinese young women has been increasing significantly, becoming the main cause of death in young female. This study aimed to investigate the characteristics and difference of risk factors in Chinese young women with ACS and to provide references for ACS prevention and treatment. Methods A 1:1 case-control study was conducted to evaluate risk factors of 415 young female patients with ACS (ACS group) who underwent PCI treatment and 415 young female cases without ACS (control group) who were hospitalized and confirmed by coronary angiography to exclude coronary heart disease from January 2010 to August 2016. The average age of the cases in the two groups was respectively (40.77±4.02) years-old and (40.57±4.01) years-old (P> 0.05). Results The risk factors in ACS group were overweight (64.10%), hypertension (49.88%), hyperlipidemia (35.66%), diabetes (23.37%), depression or anxiety disorder (16.62%), gynecological diseases (16.39%), Hyperuricemia (15.18%), family history of early onset coronary heart disease (14.94%), hyperhomocysteinemia (11.33%), hypothyroidism(14.96%), hypercholesterolemia (8.43%) and high c-reactive protein (7.47%), and were statistically significant difference (P<0.01) compared with that of control group. The average number of risk factors per case in ACS group was significantly more than that of control groups (P<0.01). There was a statistically significant difference in the number of combined risk factors of the overweight cases compared between two groups (P<0.01). Regression analysis showed that hyperlipidemia, hyperhomocysteinemia, overweight（obesity）, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases were independent risk factors (P<0.01). The bivariate correlation analysis between CRP level and age was r= -0.158 (P<0.01). This result showed the younger ACS patient is the higher serum CRP. Conclusion The independent risk factors of ACS in young women are hyperlipidemia, hyperhomocysteinemia, overweight, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases. The co-existence of multiple risk factors is the main cause suffering from ACS in young women.

scholarly journals Major clinical risk factors for seizures in febrile children aged 6 to 60 months.

2020 ◽  
Vol 27 (05) ◽  
pp. 891-894
Author(s):  
Shahid Ishaq ◽  
Ejaz Mazari ◽  
Fazal ur Rehman
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Febrile Seizures ◽  
Study Groups ◽  
Clinical Risk Factors ◽  
P Value ◽  
Chi Square ◽  
Clinical Risk ◽  
Significant Difference ◽  
History Of

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.

scholarly journals Re: Risk Factors for Breast Cancer According to Family History of Breast Cancer

1996 ◽  
Vol 88 (14) ◽  
pp. 1003-1004 ◽  
Author(s):  
F. PARAZZINI ◽  
C. L. VECCHIA ◽  
L. CHATENOUD ◽  
E. NEGRI ◽  
S. FRANCESCHI
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Family History ◽  
History Of
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