Long-Term Risk of Breast Cancer after Diagnosis of Benign Breast Disease by Screening Mammography.

Marta Román,Maria Sala,Francina Saladié,Rodrigo Alcántara,Margarita Posso,Carmen Vidal,Ivonne Vázquez,Javier Louro,María Jesús Quintana,Xavier Castells,Xavier Bargalló,Lupe Peñalva,Javier Del Riego

doi:10.3390/ijerph19052625

Abstract

Assessing the long-term risk of breast cancer after diagnosis of benign breast disease by mammography is of utmost importance to design personalised screening strategies. We analysed individual-level data from 778,306 women aged 50–69 years with at least one mammographic screening participation in any of ten breast cancer screening centers in Spain from 1996 to 2015, and followed-up until 2017. We used Poisson regression to compare the rates of incident breast cancer among women with and without benign breast disease. During a median follow-up of 7.6 years, 11,708 (1.5%) women had an incident of breast cancer and 17,827 (2.3%) had a benign breast disease. The risk of breast cancer was 1.77 times higher among women with benign breast disease than among those without (95% CI: 1.61 to 1.95). The relative risk increased to 1.99 among women followed for less than four years, and remained elevated for two decades, with relative risk 1.96 (95% CI: 1.32 to 2.92) for those followed from 12 to 20 years. Benign breast disease is a long-term risk factor for breast cancer. Women with benign breast disease could benefit from closer surveillance and personalized screening strategies.

Highlights

Benign breast disease is a major risk factor that doubles the risk of subsequent breast cancer [1,2]
A total of 17,827 (2.3%) women in the study were diagnosed with a benign breast disease, and 11,708 (1.5%) had a breast cancer diagnosis
In a previous study we found that between 40% and 45% of breast cancer cases were contralateral to the prior benign breast lesion, which has been shown in other studies [1,2]

Summary

Introduction

Benign breast disease is a major risk factor that doubles the risk of subsequent breast cancer [1,2]. Most women with a benign breast disease diagnosis are referred to routine breast cancer screening. At present, it remains uncertain how the long-term risks of breast cancer after a benign breast disease detected by screening evolves over time. There is no consensus for frequency of surveillance imaging after benign breast disease diagnosis [3–5].

Methods

Results

Conclusion