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Tang H, Lu Q, Feng S, Xiao Z, Wu W, Chen G, Deng L, Yu T, Wu J, Lin H, Ji B, Lin J, Zhang C, Li L, Liu T, Ouyang Y, Lei K, Chen J, Peng W, Qiu Z, Cai Q, Liang Q, Liu C, Li Y, Zhu L, Zhang Z, Liu X, Lin L, Zheng Z. Guidelines for the clinical application of the Xihuang pill for the prevention and treatment of breast hyperplasia diseases. PHARMACEUTICAL BIOLOGY 2024; 62:472-479. [PMID: 38769628 PMCID: PMC11110870 DOI: 10.1080/13880209.2024.2350233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
CONTEXT The Xihuang pill (XHP) is a traditional Chinese medicine formulation that has been historically used in the prevention and treatment of proliferative breast diseases. However, there is a lack of guidelines that offer recommendations for its clinical use. OBJECTIVE The task force from the Chinese Guangdong Pharmaceutical Association aims to develop evidence-based guidelines for XHP to prevent and treat proliferative breast diseases. METHODS We searched six Chinese and English electronic databases, including the China National Knowledge Infrastructure, the Chinese Scientific Journal Database, the Wanfang Medical Database, PubMed, and Embase, up to November 1, 2022. Publications (case reports, clinical observation, clinical trials, reviews) on using XHP to treat proliferative breast diseases were manually searched. The search terms were Xihuang pill, hyperplasia of the mammary gland, breast lump, and mastalgia. The writing team developed recommendations based on the best available evidence. RESULTS Treatment should be customized based on syndrome identification. We recommend using XHP for the prevention and treatment of breast hyperplasia disease when a patient presents the following syndromes: concurrent blood stasis syndrome, concurrent phlegm-stasis syndrome, and concurrent liver fire syndrome. Safety indicators, including blood analysis and liver and kidney function monitoring, should be performed regularly during treatment. CONCLUSIONS Current clinical evidence suggests that XHP can be used as a standalone treatment or in conjunction with other medications to prevent and manage breast hyperplasia diseases. More randomized controlled studies are warranted to establish high-quality evidence of its use.
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Affiliation(s)
- Hongmei Tang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qin Lu
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shiyin Feng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhiwei Xiao
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wanyin Wu
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Gaofeng Chen
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Li Deng
- The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tianqi Yu
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyan Wu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hua Lin
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Bo Ji
- Chinese PLA General Hospital of Southern Theater Command, Guangzhou, China
| | - Jietao Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chengguang Zhang
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Liming Li
- The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tao Liu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yong Ouyang
- Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, China
| | - Kaijun Lei
- Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Jun Chen
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Weiwen Peng
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Zhenwen Qiu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qingqun Cai
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qi Liang
- Shenzhen Bao’an Traditional Chinese Medicine Hospital Group, Shenzhen, China
| | - Cuiling Liu
- Shenzhen Bao’an Traditional Chinese Medicine Hospital Group, Shenzhen, China
| | - Yuzhen Li
- The Eighth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lixia Zhu
- The Eighth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zexin Zhang
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xueting Liu
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lizhu Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhihua Zheng
- Guangdong Pharmaceutical Association, Guangzhou, China
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Lohani KR, Nibbe AM, Vierkant RA, Pacheco-Spann LM, Seymour LR, Vachon CM, Sherman ME, Winham SJ, Degnim AC, Hill DA. Understanding Benign Breast Disease and Subsequent Breast Cancer in Hispanic White Females: A Step Closer to Evidence-Based Management. Cancer Epidemiol Biomarkers Prev 2024; 33:1107-1113. [PMID: 38838262 DOI: 10.1158/1055-9965.epi-24-0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/24/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Although Hispanic White (HW) females have a lower incidence of breast cancer than non-Hispanic White (NHW) females, breast cancer risk is unclear for HW females after benign breast disease (BBD). METHODS We compared BBD characteristics and subsequent breast cancer risk among HW and NHW females in New Mexico using a population-based collection of benign breast biopsies (1996-2007). BBD was categorized as nonproliferative disease (NPD), proliferative disease without atypia (PDWA), or atypical hyperplasia (AH). Breast cancer risk was assessed as absolute risk (AR) using cumulative incidence and RR by comparing the number of breast cancer events in BBDs to non-BBD. RESULTS This study included 3,684 HW and 6,587 NHW females with BBD. HW females had similar proportions of NPD (58.6% vs. 54.3%), PDWA (21.4% vs. 23.5%), and AH (3.6% vs. 3.3%) as NHW females. Breast cancer risk among all females with BBD was higher than population-based expected rates (RR, 1.87) and was similar for HW and NHW subgroups (RR = 1.99 vs. 1.84). As expected, breast cancer risk increased with increasing BBD severity, both overall [RR, 1.81 (NPD), 1.85 (PDWA), and 3.10 (AH)] and in the HW and NHW subgroups. Adjusted AR of breast cancer at 5 years also increased with the severity of BBD (HW vs. NHW; NPD: 1.4% vs. 2.1%; PDWA: 1.5% vs. 2.7%; AH: 6% vs. 4.8%). CONCLUSIONS We found similar breast cancer RRs and ARs in HW and NHW. Risk counseling should ensure that HW females receive breast cancer clinical management warranted by their similar absolute risks. IMPACT The present population-based provides evidence for the clinical management of HW females with BBD for the prevention of breast cancer.
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Affiliation(s)
- Kush R Lohani
- Division of Breast and Melanoma Surgical Oncology, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Andrea M Nibbe
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Robert A Vierkant
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Laura M Pacheco-Spann
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Lisa R Seymour
- Department of Surgery Research, Mayo Clinic, Rochester, Minnesota
| | - Celine M Vachon
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Mark E Sherman
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Stacey J Winham
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Amy C Degnim
- Division of Breast and Melanoma Surgical Oncology, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Deirdre A Hill
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
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Patil V, Ruterbusch JJ, Chen W, Boerner JL, Abdulfatah E, Alosh B, Pardeshi V, Shaik AN, Bandyopadhyay S, Ali-Fehmi R, Cote ML. Multiplicity of benign breast disease lesions and breast cancer risk in African American women. Front Oncol 2024; 14:1410819. [PMID: 38817898 PMCID: PMC11137188 DOI: 10.3389/fonc.2024.1410819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/25/2024] [Indexed: 06/01/2024] Open
Abstract
The risk of developing subsequent breast cancer is higher in women diagnosed with benign breast disease (BBD) but these studies were primarily performed in non-Hispanic white populations. Still, these estimates have been used to inform breast cancer risk models that are being used clinically across all racial and ethnic groups. Given the high breast cancer mortality rates among African American (AA) women, it is critical to study BBD in this population, to ensure the risk models that include this information perform adequately. This study utilized data from AA women who underwent benign breast biopsies at a hospital served by the University Pathology Group in Detroit, Michigan, from 1998 to 2010. Patients were followed for subsequent breast cancers through the population-based Metropolitan Detroit Cancer Surveillance System (MDCSS). BBD lesion scores were assigned to represent the severity or extent of benign breast lesions, with higher scores indicating a greater number of distinct lesion types. Of 3,461 eligible AA women with BBD in the cohort, 6.88% (n=238) subsequently developed breast cancer. Examined individually, six of the eleven lesions (apocrine metaplasia, ductal hyperplasia, lobular hyperplasia, intraductal papilloma, sclerosing adenosis, columnar alterations and radial scars) were significantly associated with increased risk of breast cancer after adjustment for age and year of biopsy and were further considered in multiple lesion models. For every different type of benign breast lesion, subsequent risk of breast cancer increased by 25% (RR=1.25, 95% CI: 1.10, 1.42) after adjustment for age at biopsy and proliferative versus non-proliferative disease. In summary, this study affirms the increased breast cancer risk in AA women with BBD, particularly in those with multiple lesions. These findings have implications for the management of breast cancer risk in millions of women affected by BBD, a high risk group that could benefit from personalized surveillance and risk reduction strategies.
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Affiliation(s)
- Vidya Patil
- Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN, United States
| | - Julie J. Ruterbusch
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Wei Chen
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Julie L. Boerner
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Eman Abdulfatah
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Baraa Alosh
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Visakha Pardeshi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Asra N. Shaik
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Sudeshna Bandyopadhyay
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Rouba Ali-Fehmi
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Michele L. Cote
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, United States
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4
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Omoleye OJ, Freeman JQ, Oluwasanu M, Adeniji-Sofoluwe A, Woodard AE, Aribisala BS, Adejumo PO, Ntekim A, Makumbi T, Ndom P, Ajayi IO, Olopade OI, Huo D. Benign breast disease and breast cancer risk in African women: a case-control study. Cancer Causes Control 2024; 35:787-798. [PMID: 38177455 DOI: 10.1007/s10552-023-01837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women. METHODS BC cases and controls were enrolled in three sub-Saharan African countries, Nigeria, Cameroon, and Uganda, between 1998 and 2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD. RESULTS Of 6,274 participants, 55.6% (3,478) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most commonly reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] 1.47, 95% CI 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR 2.25, 95% CI 1.26-4.02). BBD did not significantly mediate the effects of any of the selected BC risk factors. CONCLUSIONS In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.
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Affiliation(s)
- Olasubomi J Omoleye
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
| | - Jincong Q Freeman
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Mojisola Oluwasanu
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Anna E Woodard
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
- Data Science Institute, University of Chicago, Chicago, IL, USA
| | | | - Prisca O Adejumo
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Atara Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Timothy Makumbi
- Department of Surgery, Mulago Hospital, Mulago, Kampala, Uganda
| | - Paul Ndom
- Hôpital Général Yaoundé, Yaoundé, Cameroon
| | - IkeOluwapo O Ajayi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Olufunmilayo I Olopade
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
| | - Dezheng Huo
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA.
- Department of Public Health Sciences, University of Chicago, 5841 S. Maryland Avenue, MC 2000, Chicago, IL, 60637, USA.
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Sherman ME, Vierkant RA, Winham SJ, Vachon CM, Carter JM, Pacheco-Spann L, Jensen MR, McCauley BM, Hoskin TL, Seymour L, Gehling D, Fischer J, Ghosh K, Radisky DC, Degnim AC. Benign Breast Disease and Breast Cancer Risk in the Percutaneous Biopsy Era. JAMA Surg 2024; 159:193-201. [PMID: 38091020 PMCID: PMC10719829 DOI: 10.1001/jamasurg.2023.6382] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/08/2023] [Indexed: 12/17/2023]
Abstract
Importance Benign breast disease (BBD) comprises approximately 75% of breast biopsy diagnoses. Surgical biopsy specimens diagnosed as nonproliferative (NP), proliferative disease without atypia (PDWA), or atypical hyperplasia (AH) are associated with increasing breast cancer (BC) risk; however, knowledge is limited on risk associated with percutaneously diagnosed BBD. Objectives To estimate BC risk associated with BBD in the percutaneous biopsy era irrespective of surgical biopsy. Design, Setting, and Participants In this retrospective cohort study, BBD biopsy specimens collected from January 1, 2002, to December 31, 2013, from patients with BBD at Mayo Clinic in Rochester, Minnesota, were reviewed by 2 pathologists masked to outcomes. Women were followed up from 6 months after biopsy until censoring, BC diagnosis, or December 31, 2021. Exposure Benign breast disease classification and multiplicity by pathology panel review. Main Outcomes The main outcome was diagnosis of BC overall and stratified as ductal carcinoma in situ (DCIS) or invasive BC. Risk for presence vs absence of BBD lesions was assessed by Cox proportional hazards regression. Risk in patients with BBD compared with female breast cancer incidence rates from the Iowa Surveillance, Epidemiology, and End Results (SEER) program were estimated. Results Among 4819 female participants, median age was 51 years (IQR, 43-62 years). Median follow-up was 10.9 years (IQR, 7.7-14.2 years) for control individuals without BC vs 6.6 years (IQR, 3.7-10.1 years) for patients with BC. Risk was higher in the cohort with BBD than in SEER data: BC overall (standard incidence ratio [SIR], 1.95; 95% CI, 1.76-2.17), invasive BC (SIR, 1.56; 95% CI, 1.37-1.78), and DCIS (SIR, 3.10; 95% CI, 2.54-3.77). The SIRs increased with increasing BBD severity (1.42 [95% CI, 1.19-1.71] for NP, 2.19 [95% CI, 1.88-2.54] for PDWA, and 3.91 [95% CI, 2.97-5.14] for AH), comparable to surgical cohorts with BBD. Risk also increased with increasing lesion multiplicity (SIR: 2.40 [95% CI, 2.06-2.79] for ≥3 foci of NP, 3.72 [95% CI, 2.31-5.99] for ≥3 foci of PDWA, and 5.29 [95% CI, 3.37-8.29] for ≥3 foci of AH). Ten-year BC cumulative incidence was 4.3% for NP, 6.6% for PDWA, and 14.6% for AH vs an expected population cumulative incidence of 2.9%. Conclusions and Relevance In this contemporary cohort study of women diagnosed with BBD in the percutaneous biopsy era, overall risk of BC was increased vs the general population (DCIS and invasive cancer combined), similar to that in historical BBD cohorts. Development and validation of pathologic classifications including both BBD severity and multiplicity may enable improved BC risk stratification.
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Affiliation(s)
- Mark E. Sherman
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | | | | | | | - Jodi M. Carter
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | - Tanya L. Hoskin
- Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Lisa Seymour
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Denice Gehling
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Karthik Ghosh
- Department of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Amy C. Degnim
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
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Song JE, Jang JY, Kang KN, Jung JS, Kim CW, Kim AS. Multi-MicroRNA Analysis Can Improve the Diagnostic Performance of Mammography in Determining Breast Cancer Risk. Breast J 2023; 2023:9117047. [PMID: 38178922 PMCID: PMC10764649 DOI: 10.1155/2023/9117047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/14/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024]
Abstract
The objective of this study was to determine whether multi-microRNA analysis using a combination of four microRNA biomarkers (miR-1246, 202, 21, and 219B) could improve the diagnostic performance of mammography in determining breast cancer risk by age group (under 50 vs. over 50) and distinguish breast cancer from benign breast diseases and other cancers (thyroid, colon, stomach, lung, liver, and cervix cancers). To verify breast cancer classification performance of the four miRNA biomarkers and whether the model providing breast cancer risk score could distinguish between benign breast disease and other cancers, the model was verified using nonlinear support vector machine (SVM) and generalized linear model (GLM) and age and four miRNA qRT-PCR analysis values (dCt) were input to these models. Breast cancer risk scores for each Breast Imaging-Reporting and Data System (BI-RADS) category in multi-microRNA analysis were analyzed to examine the correlation between breast cancer risk scores and mammography categories. We generated two models using two classification algorithms, SVM and GLM, with a combination of four miRNA biomarkers showing high performance and sensitivities of 84.5% and 82.1%, a specificity of 85%, and areas under the curve (AUCs) of 0.967 and 0.965, respectively, which showed consistent performance across all stages of breast cancer and patient ages. The results of this study showed that this multi-microRNA analysis using the four miRNA biomarkers was effective in classifying breast cancer in patients under the age of 50, which is challenging to accurately diagnose. In addition, breast cancer and benign breast diseases can be classified, showing the possibility of helping with diagnosis by mammography. Verification of the performance of the four miRNA biomarkers confirmed that multi-microRNA analysis could be used as a new breast cancer screening aid to improve the accuracy of mammography. However, many factors must be considered for clinical use. Further validation with an appropriate screening population in large clinical trials is required. This trial is registered with (KNUCH 2022-04-036).
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Affiliation(s)
- Ji-Eun Song
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea
| | - Ji Young Jang
- BIOINFRA Life Science Inc., Jongno-gu, Seoul 03127, Republic of Korea
| | - Kyung Nam Kang
- BIOINFRA Life Science Inc., Jongno-gu, Seoul 03127, Republic of Korea
| | - Ji Soo Jung
- BIOINFRA Life Science Inc., Jongno-gu, Seoul 03127, Republic of Korea
| | - Chul Woo Kim
- BIOINFRA Life Science Inc., Jongno-gu, Seoul 03127, Republic of Korea
| | - Ah Sol Kim
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea
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7
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Omoleye OJ, Freeman JQ, Oluwasanu M, Adeniji-Sofoluwe A, Woodard AE, Aribisala BS, Adejumo PO, Ntekim A, Makumbi T, Ndom P, Ajayi IO, Olopade OI, Huo D. Benign breast disease and breast cancer risk in African women: A case-control study. RESEARCH SQUARE 2023:rs.3.rs-3301977. [PMID: 37693385 PMCID: PMC10491333 DOI: 10.21203/rs.3.rs-3301977/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Purpose To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women. Methods BC cases and matched controls were enrolled in three sub-Saharan African countries, Nigeria Cameroon, and Uganda, between 1998-2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD. Results Of 6418 participants, 55.7% (3572) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] = 1.47, 95% CI: 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR = 3.11, 95% CI: 1.78-5.44). BBD did not significantly mediate the effects of any of the selected BC risk factors. Conclusions In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.
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8
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Patel H, Raghuram A, McClure KE, Alcon A, DeStefano L, Srinivasa DR. A Comprehensive Analysis of Breast Malignancies in Transgender Patients: A Systematic Review of Breast Cancer Incidence and Pathology with Provider Survey Results on Long-Term Screening. Transgend Health 2022. [DOI: 10.1089/trgh.2021.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Harsh Patel
- Department of Plastics and Reconstructive Surgery at Cedars-Sinai Medical Center, University of California Los Angeles (UCLA), Los Angeles, California, USA
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | | | - Kelsey E. McClure
- Division of Plastic and Reconstructive Surgery at University of California San Francisco (UCSF), San Francisco, California, USA
| | - Andre Alcon
- Division of Plastic and Reconstructive Surgery at University of California San Francisco (UCSF), San Francisco, California, USA
| | - Lauren DeStefano
- Department of Surgery at Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dhivya R. Srinivasa
- Department of Plastics and Reconstructive Surgery at Cedars-Sinai Medical Center, University of California Los Angeles (UCLA), Los Angeles, California, USA
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9
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Zhang J, Li H, Lin L, Lu J, Wang H. Ultrasound-guided microwave ablation for multiple benign breast lesions: A prospective study. J Obstet Gynaecol Res 2021; 47:3362-3369. [PMID: 34110061 DOI: 10.1111/jog.14823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 04/02/2021] [Accepted: 04/30/2021] [Indexed: 11/30/2022]
Abstract
AIM To provide medical evidence for the feasibility and clinical efficacy of microwave ablation (MWA) in the treatment of benign breast lesions, especially multiple benign breast lesions. METHODS We included patients with multiple benign breast lesions who were seen at our hospital during the period from June 2016 to December 2017. After signed informed consent had been obtained and core breast biopsy, all included patients who underwent MWA at 2450 MHz with 30 W power adjustment. Postoperative follow-up was performed for 1 year, at 3-month intervals. Ablation time, complications, volume-reduction ratio (VRR), and lesion residuals after ablation were analyzed. RESULTS We ultimately included 1274 lesions from 164 cases in the study with a median follow-up time of 13.6 months. For a single lesion, the median ablation time was 36 s. Pain, fat liquefaction, and skin scalding were the most common complications. The overall complete disappearance rate was 92.1% (1173/1274), with the highest complete disappearance rate observed among those patients with lesions <10 mm in diameter (942/968, 97.3%). For lesions that persisted at 12 months after MWA, the average the volume-reduction ratio (VRR) was 87.5%. CONCLUSIONS For multiple benign lesions of the breast, especially lesions with the longest diameter <10 mm, ultrasound guided MWA is a minimally invasive, relatively quick therapeutic strategy associated with accuracy in treatment and few complications.
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Affiliation(s)
- Jinfan Zhang
- Department of Breast Surgery, The Affiliated Hospital of Putian University, Putian, China
| | - Hang Li
- Department of Breast Surgery, The Affiliated Hospital of Putian University, Putian, China
| | - Lisheng Lin
- Department of Breast Surgery, The Affiliated Hospital of Putian University, Putian, China
| | - Jingyu Lu
- Department of Breast Surgery, The Affiliated Hospital of Putian University, Putian, China
| | - Hongling Wang
- Department of General Surgery, Hebei Province Traditional Chinese Medical Hospital, Shijiazhuang, China
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10
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Shaik AN, Kiavash K, Stark K, Boerner JL, Ruterbusch JJ, Deirawan H, Bandyopadhyay S, Ali-Fehmi R, Dyson G, Cote ML. Inflammation markers on benign breast biopsy are associated with risk of invasive breast cancer in African American women. Breast Cancer Res Treat 2020; 185:831-839. [PMID: 33113091 DOI: 10.1007/s10549-020-05983-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Markers of inflammation, including crown-like structures of the breast (CLS-B) and infiltrating lymphocytes (IL), have been identified in breast tissue and associated with increased risk of breast cancer (BrCa), however most of this work has been performed in primarily non-Hispanic white women. Here, we examined whether CLS-B and IL are associated with invasive BrCa in African American (AA) women. METHODS We assessed breast biopsies from three 5-year age-matched groups: BrCa-free AA women (50 Volunteer) from the Komen Normal Tissue Bank (KTB) and AA women with a clinically-indicated biopsy diagnosed with benign breast disease (BBD) from our Detroit cohort who developed BrCa (55 BBD-cancer) or did not develop BrCa (47 BBD only, year of biopsy matched to BBD-cancer). Mean adipocyte diameter and total adipose area were estimated from digital images using the Adiposoft plugin from ImageJ. Associations between CLS-B, IL, and BrCa among KTB and Detroit biopsies were assessed using multivariable multinomial and conditional logistic regression models. RESULTS Among all biopsies, Volunteer and BBD only biopsies did not harbor CLS-B or IL at significantly different rates after adjusting for logarithm of adipocyte area, adipocyte diameter, and BMI. Among clinically-indicated BBD biopsies, BBD-cancer biopsies were more likely to exhibit CLS-B (odds ratio (OR) = 3.36, 95% Confidence Interval (CI): 1.33-8.48) or IL (OR = 4.95, 95% CI 1.76-13.9) than BBD only biopsies after adjusting for total adipocyte area, adipocyte diameter, proliferative disease, and BMI. CONCLUSIONS CLS-B and IL may serve as histological markers of BrCa risk in benign breast biopsies from AA women.
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Affiliation(s)
- Asra N Shaik
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Katrin Kiavash
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Karri Stark
- Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Julie L Boerner
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Julie J Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hany Deirawan
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Sudeshna Bandyopadhyay
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Gregory Dyson
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Michele L Cote
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA. .,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA.
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11
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Xiong J, Li H, Hua F, Huang S, Xiang J, Jiang Y, Liao K, Zhou X, Liu M. Acupuncture for mammary gland hyperplasia: A Bayesian network meta-analysis protocol. Medicine (Baltimore) 2020; 99:e22055. [PMID: 32899068 PMCID: PMC7478577 DOI: 10.1097/md.0000000000022055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Multiple randomized controlled trials have shown that acupuncture (ACU) work well in the treating mammary gland hyperplasia, which has been widely used in hospitals of China. Although the choices of ACU treatments varies in practice, most are based on experience or preference. Therefore, we outline a plan to assess and rank the efficacy of the various ACU methods to formulate a prioritized regimen for mammary gland hyperplasia in ACU therapy. METHODS We will make a comprehensive retrieval in 7 databases as following: PubMed, Embase, Cochrane Library, China BioMedical Literature, China National Knowledge Infrastructure, Chinese Scientific Journals Database, and Wanfang database. The time is limited from the construction of the library to June 2020. We will evaluate the quality and the evidence of the included randomized controlled trials by the risk of bias tool and grading of recommendations assessment, development and evaluation, respectively. Bayesian network meta-analysis will be conducted using Stata16.0 and WinBUGS V.1.4.3. RESULTS The results of this study will be published in a peer-reviewed journal. CONCLUSIONS Our study is expected to provide high-quality, evidence-based recommendations on further treatment of MGH for clinicians. REGISTRATION PROSPERO (registration number CRD42020158743).
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Affiliation(s)
- Jun Xiong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Honglian Li
- Haiyang People's Hospital of Shandong Province, Haiyang
| | - Fanghui Hua
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Shouqiang Huang
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jie Xiang
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yunfeng Jiang
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Kai Liao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Xiaohong Zhou
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Meihua Liu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
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12
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Benign breast conditions: An eight-year single-centre histopathological review of women presenting with mass lesions at the Korle-Bu Teaching Hospital, Ghana. Ann Diagn Pathol 2019; 42:33-38. [DOI: 10.1016/j.anndiagpath.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/26/2019] [Accepted: 07/07/2019] [Indexed: 11/22/2022]
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13
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Odedina SO, Ajayi IO, Adeniji-Sofoluwe A, Morhason-Bello IO, Huo D, Olopade OI, Ojengbede OA. A longitudinal study of the prevalence and characteristics of breast disorders detected by clinical breast examination during pregnancy and six months postpartum in Ibadan, Southwestern Nigeria. BMC WOMENS HEALTH 2018; 18:152. [PMID: 30231883 PMCID: PMC6147054 DOI: 10.1186/s12905-018-0647-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/12/2018] [Indexed: 01/29/2023]
Abstract
Background Breast disorders cause great anxiety for women especially when they occur in pregnancy because breast cancer is the most common cause of cancer related deaths in women. Majority of the disorders are Benign Breast Diseases (BBD) with various degrees of associated breast cancer risks. With increasing breast cancer awareness in Nigeria, we sought to determine the prevalence and characteristics of breast disorders among a cohort of pregnant women. Methods A longitudinal study of 1248 pregnant women recruited in their first trimester- till 26 weeks gestational age consecutively from selected antenatal clinics (ANCs), in Ibadan, Southwest Nigeria. A pretested interviewer- administered questionnaire was used to collect information at recruitment. Clinical Breast Examination (CBE) using MammaCare® technique was performed at recruitment and follow up visits at third trimester, six weeks postpartum and six months postpartum. Women with breast disorders were referred for Breast Ultrasound Scan (BUS) and those with Breast Imaging Reporting and Data System (BIRADS) ≥4 had ultrasound guided biopsy. Statistical analysis was performed using Stata version 14. Results Mean age of participants was 29.7 ± 5.2 years and mean gestational age at recruitment was 20.4 ± 4.4 weeks. Seventy-two participants (5.8%) had a past history of BBD and 345 (27.6%) were primigravidae. Overall, breast disorder was detected among 223 (17.9%) participants and 149 (11.9%) had it detected at baseline. Findings from the CBE showed that 208 (69.6%) of 299 breast disorders signs found were palpable lumps or thickenings in the breast, 28 (9.4%) were persistent pain, and 63 (21.1%) were abscesses, infection and mastitis. Twenty out of 127 (15.7%) participants who had BUS performed were classified as BIRADS ≥3. Lesions found by BUS were reactive lymph nodes (42.5%), prominent ducts (27.1%), fibroadenoma (9.6%), breast cysts (3.8%) and fibrocystic changes (2.5%). No malignant pathology was found on ultrasound guided biopsy. Conclusions Breast lump is a major breast disorder among pregnant women attending antenatal clinics in Ibadan. Routine clinical breast examination and follow up of pregnant women found with breast disorders could facilitate early detection of pregnancy associated breast cancer in low resource settings.
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Affiliation(s)
- Stella O Odedina
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.
| | - IkeOluwapo O Ajayi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.
| | | | - Imran O Morhason-Bello
- Centre for Population and Reproductive Health, College of Medicine, Ibadan, Nigeria.,Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Dezheng Huo
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | | | - Oladosu A Ojengbede
- Centre for Population and Reproductive Health, College of Medicine, Ibadan, Nigeria.,Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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14
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Shaik AN, Ruterbusch JJ, Abdulfatah E, Shrestha R, Daaboul MHDF, Pardeshi V, Visscher DW, Bandyopadhyay S, Ali-Fehmi R, Cote ML. Breast fibroadenomas are not associated with increased breast cancer risk in an African American contemporary cohort of women with benign breast disease. Breast Cancer Res 2018; 20:91. [PMID: 30092846 PMCID: PMC6085691 DOI: 10.1186/s13058-018-1027-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibroadenomas are common benign breast lesions, and studies of European American women indicate a persistent, increased risk of breast cancer after diagnosing a fibroadenoma on biopsy. This association has not been independently assessed in African American women, despite reports that these women are more likely to present with fibroadenomas. METHODS The study cohort included 3853 African American women with a breast biopsy completed between 1997 and 2010 in metropolitan Detroit. Biopsies were microscopically reviewed for benign breast lesions, including fibroadenoma, proliferative disease, and atypia. Risk of breast cancer within the cohort was estimated using relative risk ratios and 95% CIs calculated using multivariable log-binomial regression. Relative risk of breast cancer in this cohort compared with African American women in the broader metropolitan Detroit population was estimated using standardized incidence ratios (SIRs). RESULTS Fibroadenomas occurred more frequently in biopsies of younger women, and other types of benign breast lesions were less likely to occur when a fibroadenoma was present (p = 0.008 for lobular hyperplasia; all other p values < 0.01). Unlike women with other benign lesions (SIR, 1.41; 95% CI, 1.20, 1.66), women with fibroadenomas did not have an increased risk of developing breast cancer compared with the general population (SIR, 0.94; 95% CI, 0.75, 1.18). Biopsies that indicated a fibroadenoma were associated with a reduced risk of breast cancer after adjusting for age at biopsy, proliferation, and atypia (relative risk, 0.67; 95% CI, 0.48, 0.93) compared with biopsies without a fibroadenoma. CONCLUSIONS These findings have important implications for breast cancer risk models and clinical assessment, particularly among African American women, in whom fibroadenomas are common.
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Affiliation(s)
- Asra N Shaik
- Department of Oncology, Wayne State University School of Medicine, 4100 John R Street, MM04EP, Detroit, MI, 48201, USA
| | - Julie J Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, 4100 John R Street, MM04EP, Detroit, MI, 48201, USA
| | - Eman Abdulfatah
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Resha Shrestha
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - M H D Fayez Daaboul
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Visakha Pardeshi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Daniel W Visscher
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Michele L Cote
- Department of Oncology, Wayne State University School of Medicine, 4100 John R Street, MM04EP, Detroit, MI, 48201, USA.
- Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
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15
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Salamat F, Niakan B, Keshtkar A, Rafiei E, Zendehdel M. Subtypes of Benign Breast Disease as a Risk Factor of Breast Cancer: A Systematic Review and Meta Analyses. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:355-364. [PMID: 30046203 PMCID: PMC6055208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Researchers suggest that benign breast disease (BBD) is a key risk factor for breast cancer. The present study aimed to determinate the risk level of breast cancer in terms of various BBD subgroups. METHODS A meta-analysis was performed to determinate the risk of breast cancer associated with BBD. Observational studies (traditional case-control studies, nested case-control studies, and cohort studies) published from January 2000 to June 2015 were assessed to evaluate the risk of developing breast cancer related to BBD. Various databases such as Medline (PubMed), Web of Science (ISI), Scopus, and Google Scholar were searched. The additional search included the Journal of Breast Cancer Research and Treatment and the Journal of Cancer Research. RESULTS Twenty studies out of 21 were used to estimate the risk of developing breast cancer related to proliferative disease without atypia versus non-proliferative disease and the reported risk ranged from 1.04 to 1.83. The reported risk of developing breast cancer related to proliferative disease with atypia versus non-proliferative disease in 21 studies ranged from 1.59 to 4.74. Based on 20 studies, the pooled risk estimates for developing breast cancer related to proliferative disease without atypia versus non-proliferative disease was 1.58 (95% CI: 1.51-1.66). Based on 21 studies, the pooled risk estimates for developing breast cancer related to proliferative disease with atypia versus non-proliferative disease was 3.49 (95% CI: 3.23-3.77). CONCLUSION The overall result of this review showed an elevated risk for breast cancer related to BBD subtypes. We propose better strategies for screening recommendations for such women.
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Affiliation(s)
- Fatemeh Salamat
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Babak Niakan
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Rafiei
- Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Manoosh Zendehdel
- Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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16
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Zendehdel M, Niakan B, Keshtkar A, Rafiei E, Salamat F. Subtypes of Benign Breast Disease as a Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis Protocol. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:1-8. [PMID: 29398746 PMCID: PMC5775989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breast cancer is a multifactorial disease. Benign breast disease (BBD) is one of the most important risk factors for breast cancer. The etiology of BBD is unknown. It is divided into nonproliferative and proliferative diseases. The selection of studies will be based on titles, abstract screening, inclusion and exclusion criteria, and quality assessment. Previous studies have shown that all types of BBD increase the risk of breast cancer, but the risk degree is different for each one. Accurate risk estimation of breast cancer in each category can be very important for proper clinical management. This systematic review and meta-analysis will be conducted on observational studies (traditional case control, nested case control, case cohort, and cohort) published in the Web of Science (ISI), PubMed (MEDLINE), Scopus, Google Scholar, and the key journals of this field such as Breast Cancer Research and Treatment and Cancer Research from January 2000 to June 2015. Reference lists and gray literature will be reviewed too. All the initial retrievals will be performed by 2 researchers independently. The data extraction form will consist of general information concerning the studies, study eligibility, method, risk of bias assessment, and results-including odds ratios, risk ratios, rate ratios, and hazard ratios. The PRISMA and MOOSE guidelines will be used to report our findings. Registration Details: PROSPERO-42016035243.
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Affiliation(s)
- Manoosh Zendehdel
- Research Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, Iran
| | - Babak Niakan
- Guilan University of Medical Sciences, Rasht, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Rafiei
- Research Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Salamat
- Research Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, Iran,Correspondence: Fatemeh Salamat, MS; Research Vice-Chancellorship, Guilan University of Medical Sciences, Postal Code: 41938-93345, Rasht, Iran Tel: +98 911 2372989 Fax: +98 13 33362842
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17
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Newman LA, Stark A, Chitale D, Pepe M, Longton G, Worsham MJ, Nathanson SD, Miller P, Bensenhaver JM, Proctor E, Swain M, Patriotis C, Engstrom PF. Association Between Benign Breast Disease in African American and White American Women and Subsequent Triple-Negative Breast Cancer. JAMA Oncol 2017; 3:1102-1106. [PMID: 28006062 DOI: 10.1001/jamaoncol.2016.5598] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Importance Compared with white American (WA) women, African American (AA) women have a 2-fold higher incidence of breast cancers that are negative for estrogen receptor, progesterone receptor, and ERBB2 (triple-negative breast cancer [TNBC]). Triple-negative breast cancer, compared with non-TNBC, likely arises from different pathogenetic pathways, and benign breast disease (BBD) predicts future non-TNBC. Objective To determine whether AA identity remains associated with TNBC for women with a prior diagnosis of BBD. Design, Setting, and Participants This study is a retrospective analysis of data of a cohort of 2588 AA and 3566 WA women aged between 40 and 70 years with a biopsy-proven BBD diagnosis. The data-obtained from the Pathology Information System of Henry Ford Health System (HFHS), an integrated multihospital and multispecialty health care system headquartered in Detroit, Michigan-include specimens of biopsies performed between January 1, 1994, and December 31, 2005. Data analysis was performed from November 1, 2015, to June 15, 2016. Main Outcomes and Measures Subsequent breast cancer was stratified on the basis of combinations of hormone receptor and ERBB2 expression. Results Case management, follow-up, and outcomes received or obtained by our cohort of 2588 AA and 3566 WA patients were similar, demonstrating that HFHS delivered care equitably. Subsequent breast cancers developed in 103 (4.1%) of AA patients (mean follow-up interval of 6.8 years) and 143 (4.0%) of WA patients (mean follow-up interval of 6.1 years). More than three-quarters of subsequent breast cancers in each subset were ductal carcinoma in situ or stage I. The 10-year probability estimate for developing TNBC was 0.56% (95% CI, 0.32%-1.0%) for AA patients and 0.25% (95% CI, 0.12%-0.53%) for WA patients. Among the 66 AA patients who developed subsequent invasive breast cancer, 16 (24.2%) developed TNBC compared with 7 (7.4%) of the 94 WA patients who developed subsequent invasive breast cancers and had complete biomarker data (P = .01). Conclusions and Relevance This study is the largest analysis to date of TNBC in the context of racial/ethnic identity and BBD as risk factors. The study found that AA identity persisted as a significant risk factor for TNBC. This finding suggests that AA identity is associated with inherent susceptibility for TNBC pathogenetic pathways.
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Affiliation(s)
- Lisa A Newman
- Breast Oncology Program, Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, Michigan
| | - Azadeh Stark
- Breast Oncology Program, Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, Michigan.,Breast Oncology Program, Department of Pathology, Henry Ford Health System, Detroit, Michigan
| | - Dhanajay Chitale
- Breast Oncology Program, Department of Pathology, Henry Ford Health System, Detroit, Michigan
| | - Margaret Pepe
- Department of Biostatistics and Biomathematics, Fred Hutchinson Comprehensive Cancer Center, Seattle, Washington
| | - Gary Longton
- Department of Biostatistics and Biomathematics, Fred Hutchinson Comprehensive Cancer Center, Seattle, Washington
| | - Maria J Worsham
- Breast Oncology Program, Department of Otolaryngology, Henry Ford Health System, Detroit, Michigan
| | - S David Nathanson
- Breast Oncology Program, Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, Michigan
| | - Patricia Miller
- Breast Oncology Program, Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - Jessica M Bensenhaver
- Breast Oncology Program, Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, Michigan
| | - Erica Proctor
- Breast Oncology Program, Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, Michigan
| | - Monique Swain
- Breast Oncology Program, Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, Michigan
| | - Christos Patriotis
- Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
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18
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Serum IGFBP-2 and Risk of Atypical Hyperplasia of the Breast. J Cancer Epidemiol 2015; 2015:203284. [PMID: 26106415 PMCID: PMC4464590 DOI: 10.1155/2015/203284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/12/2015] [Indexed: 12/21/2022] Open
Abstract
Atypical hyperplasia of the breast (AH) is associated with increased risk of subsequent invasive breast cancer, yet little is known about the etiology of AH. Insulin-like growth factor binding protein 2 (IGFBP-2) may contribute to the development of AH due to its proliferative effects on mammary tissue. We conducted a nested case-control study of postmenopausal women enrolled in Women's Health Initiative-Clinical Trial. Cases were 275 women who developed incident AH during follow-up, individually (1 : 1) matched to controls. Levels of IGFBP-2 were determined from fasting serum collected at baseline. Multivariable conditional logistic regression models were used to estimate odds ratios for the association of IGFBP-2 with risk of AH. Serum IGFBP-2 was associated with a nonsignificant decrease in risk for AH, when comparing the highest quartile to lowest quartile (OR = 0.65; 95% CI = 0.32–1.31). This decrease in risk was most evident when analyses were restricted to nondiabetic, nonusers of hormone therapy (OR = 0.33, 95% CI = 0.13–0.86, ptrend = 0.06) and nondiabetic women who were overweight or obese (OR = 0.43, 95% CI = 0.18–1.03, ptrend = 0.05). Results from this study provide some support for an inverse association between serum IGFBP2 levels and risk of AH, particularly in nondiabetic women who are overweight or obese. Further studies are required to confirm these results.
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19
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Hornberger J, Chen SC, Li Q, Kakad P, Quay SC. Proliferative epithelial disease identified in nipple aspirate fluid and risk of developing breast cancer: a systematic review. Curr Med Res Opin 2015; 31:253-62. [PMID: 25405383 DOI: 10.1185/03007995.2014.988209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Guideline panels recognize the need to increase the accuracy of identifying women at high risk of developing breast cancer who would benefit from prevention strategies. The characterization of proliferative epithelial disease found in nipple aspirate fluid (PED-NAF) may be a relevant risk factor. OBJECTIVE To comprehensively review the published literature to characterize and summarize abnormal cytology detected by NAF and the association of PED-NAF with subsequent risk of developing breast cancer. RESEARCH DESIGN AND METHODS Literature identified by systematic searches in MEDLINE PubMed and the Cochrane Library was screened for articles containing primary data on NAF cytology based on predefined inclusion and exclusion criteria. MAIN OUTCOME MEASURES Study characteristics, cytological group distribution, and incidence of breast cancer. RESULTS Thirty articles were included after full-text review, of which 16 were analyzed, containing data on 20,808 unique aspirations from over 17,378 subjects. Seven (44%) of the studies used the King cytological classification system. Among aspirations from women free of breast cancer, 51.5% contained fluid, in which over 27.7% had PED on cytology. In the two prospective studies of 7850 cancer-free women, abnormal cytology by NAF carried a 2.1-fold higher risk (95% CI, 1.6-2.6; p < 0.001) of developing breast cancer, compared with women from whom no fluid could be obtained. CONCLUSIONS PED-NAF among women free of breast cancer, compared with no fluid being obtained, has an independent risk of developing breast cancer comparable to the risk of a woman with a positive family history of breast cancer. These findings have implications for augmenting risk prediction and clinical decisions concerning breast cancer surveillance and chemoprevention. As with all reviews, heterogeneity across studies may have influenced the results. The limited literature calls for prospective studies on asymptomatic women with long-term follow-up.
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Affiliation(s)
- John Hornberger
- Department of Internal Medicine, Stanford University School of Medicine , Stanford, CA , USA
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20
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Castells X, Domingo L, Corominas JM, Torá-Rocamora I, Quintana MJ, Baré M, Vidal C, Natal C, Sánchez M, Saladié F, Ferrer J, Vernet M, Servitja S, Rodríguez-Arana A, Roman M, Espinàs JA, Sala M. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program. Breast Cancer Res Treat 2015; 149:237-44. [PMID: 25503778 PMCID: PMC4298666 DOI: 10.1007/s10549-014-3208-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 11/10/2014] [Indexed: 11/30/2022]
Abstract
Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.
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Affiliation(s)
- Xavier Castells
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Pg. Marítim 25-29, 08003, Barcelona, Catalonia, Spain,
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von Euler-Chelpin M, Kuchiki M, Vejborg I. Increased risk of breast cancer in women with false-positive test: The role of misclassification. Cancer Epidemiol 2014; 38:619-22. [DOI: 10.1016/j.canep.2014.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 06/16/2014] [Accepted: 06/22/2014] [Indexed: 10/25/2022]
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Mitro SD, Ali-Fehmi R, Bandyopadhyay S, Alosh B, Albashiti B, Radisky DC, Frost MH, Degnim AC, Ruterbusch JJ, Cote ML. Clinical characteristics of breast cancers in African-American women with benign breast disease: a comparison to the surveillance, epidemiology, and end results program. Breast J 2014; 20:571-7. [PMID: 25200244 DOI: 10.1111/tbj.12331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Benign breast disease (BBD) is a very common condition, diagnosed in approximately half of all American women throughout their lifecourse. White women with BBD are known to be at substantially increased risk of subsequent breast cancer; however, nothing is known about breast cancer characteristics that develop after a BBD diagnosis in African-American women. Here, we compared 109 breast cancers that developed in a population of African-American women with a history of BBD to 10,601 breast cancers that developed in a general population of African-American women whose cancers were recorded by the Metropolitan Detroit Cancer Surveillance System (MDCSS population). Demographic and clinical characteristics of the BBD population were compared to the MDCSS population, using chi-squared tests, Fisher's exact tests, t-tests, and Wilcoxon tests where appropriate. Kaplan-Meier curves and Cox regression models were used to examine survival. Women in the BBD population were diagnosed with lower grade (p = 0.02), earlier stage cancers (p = 0.003) that were more likely to be hormone receptor-positive (p = 0.03) compared to the general metropolitan Detroit African-American population. In situ cancers were more common among women in the BBD cohort (36.7%) compared to the MDCSS population (22.1%, p < 0.001). Overall, women in the BBD population were less likely to die from breast cancer after 10 years of follow-up (p = 0.05), but this association was not seen when analyses were limited to invasive breast cancers. These results suggest that breast cancers occurring after a BBD diagnosis may have more favorable clinical parameters, but the majority of cancers are still invasive, with survival rates similar to the general African-American population.
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Affiliation(s)
- Susanna D Mitro
- School of Public Health, University of Michigan, Ann Arbor, Michigan
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Okoth C, Galukande M, Jombwe J, Wamala D. Benign proliferative breast diseases among female patients at a sub-Saharan Africa tertiary hospital: a cross sectional study. BMC Surg 2013; 13:9. [PMID: 23548039 PMCID: PMC3623623 DOI: 10.1186/1471-2482-13-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 03/27/2013] [Indexed: 11/10/2022] Open
Abstract
Background Non-cancerous diseases of the breast have assumed increasing importance because of the public awareness of breast cancer. These benign diseases are a recognized important risk factor for later breast cancer which can develop in either breast. The risk estimate of these benign breast diseases has not been well established in sub Saharan Africa. Women with benign proliferative or atypical breast lesions have a two- fold risk of developing breast cancer in western populations. The purpose of this study therefore was to determine the prevalence of proliferative disease ( BPBD) with and without atypia among Ugandan Black women. Methods A cross-sectional descriptive study conducted at Mulago Hospital Breast Clinic between January 2012 and June 2012; 208 women aged 12 years and above with palpable breast lumps were screened. Fine needle aspiration biopsies were taken for cytological examination. Results Of the 208 women with benign breast lumps screened, 195 were recruited in the study. The prevalence of BPBD was 18% (35/195). BPBD with atypia was 5.6% (11/195). The mean age and body mass index (BMI) were 28.4 years and 23.26 kg/m2 respectively. The commonest lesions were fibroadenomas for 57%, (111/195), and fibrocystic change were 21% (40/195). Most BPBD with atypia lesions were in the fibrocystic category. Conclusions Benign proliferative breast diseases are common, found mostly among premenopausal women. A significant proportion of BPBD had atypical proliferation. An accurate breast cancer risk estimate study for BPBD is recommended.
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Affiliation(s)
- Christopher Okoth
- Department of Surgery, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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