Abstract
IntroductionHistologic and genetic evidence suggests that at least some columnar cell lesions (CCL) of the breast represent precursor lesions in the low-grade breast neoplasia pathway. However, the risk of subsequent breast cancer associated with the presence of CCL in a benign breast biopsy is poorly understood.MethodsThe authors examined the association between the presence of CCL and subsequent breast cancer risk in a nested case-control study of benign breast disease (BBD) and breast cancer within the Nurses' Health Studies (394 cases, 1,606 controls). Benign breast biopsy slides were reviewed by pathologists and CCL presence assessed. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the association between CCL and breast cancer risk.ResultsWomen with CCL (140 cases, 448 controls) had an increased risk of breast cancer compared with those without CCL (OR = 1.44, 95% CI: 1.14 to 1.83), although this was attenuated and became non-significant after adjustment for the histologic category of BBD (OR = 1.20, 95% CI: 0.94 to 1.54). CCL presence was associated with the greatest risk of breast cancer for those with nonproliferative BBD (OR = 1.36, 95% CI: 0.79 to 2.37) and the lowest risk for those with atypical hyperplasia (AH) (OR = 1.10, 95% CI: 0.65 to 1.87); however, this apparent heterogeneity in risk across BBD categories was not significant (P for interaction between CCL presence and BBD category = 0.77).ConclusionsThese results provide evidence that CCL may be an important marker of breast cancer risk in women with BBD but suggest that CCL do not increase breast cancer risk independently of concurrent proliferative changes in the breast.
Highlights
Histologic and genetic evidence suggests that at least some columnar cell lesions (CCL) of the breast represent precursor lesions in the low-grade breast neoplasia pathway
Histologic subtype of benign breast disease (BBD) was strongly associated with presence of CCL, with women having CCL much more likely to have proliferative disease and atypical hyperplasia (AH) compared with women without CCL (P < 0.0001)
Few previous epidemiologic analyses have evaluated the risk of subsequent breast cancer following detection of CCL, but the magnitude of risk associated with the presence of CCL found in our study is consistent with that reported by Boulos et al in a large retrospective cohort study among women in the Nashville Breast Cohort
Summary
Histologic and genetic evidence suggests that at least some columnar cell lesions (CCL) of the breast represent precursor lesions in the low-grade breast neoplasia pathway. With the widespread adoption of screening mammography in the past several decades, columnar cell lesions (CCL) of the breast have become a frequent finding in breast biopsies. These lesions have been reported to be present in nearly half of biopsies performed for mammographic microcalcifications and have been identified as the source of three-quarters of biopsy-detected microcalcifications [1]. CCL is a broad designation that encompasses a wide range of histologic changes ranging from alterations of the epithelium with no architectural or cytologic atypia to changes resembling ductal carcinoma in situ (DCIS) [2] These lesions have been recognized for some time, the diverse terminology. The presence of CCL in proximity to invasive and non-invasive breast cancer suggests that CCL may have the potential to undergo malignant transformation, CCL may be markers for other precancerous conditions in the breast
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
