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Positive Association of Fibroadenomatoid Change with HER2-Negative Invasive Breast Cancer: A Co-Occurrence Study.

Chen Y, Bekhash A, Kovatich AJ, Hooke JA, Liu J, Kvecher L, Fantacone-Campbell JL, Mitchell EP, Rui H, Mural RJ, Shriver CD, Hu H - PLoS ONE (2015)

Bottom Line: Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC.This association is only significant with HER2-negative IBC subtypes.We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA.

View Article: PubMed Central - PubMed

Affiliation: Biomedical Informatics, Windber Research Institute, Windber, Pennsylvania, United States of America.

ABSTRACT

Background: Risk assessment of a benign breast disease/lesion (BBD) for invasive breast cancer (IBC) is typically done through a longitudinal study. For an infrequently-reported BBD, the shortage of occurrence data alone is a limiting factor to conducting such a study. Here we present an approach based on co-occurrence analysis, to help address this issue. We focus on fibroadenomatoid change (FAC), an under-studied BBD, as our preliminary analysis has suggested its previously unknown significant co-occurrence with IBC.

Methods: A cohort of 1667 female patients enrolled in the Clinical Breast Care Project was identified. A single experienced breast pathologist reviewed all pathology slides for each case and recorded all observed lesions, including FAC. Fibroadenoma (FA) was studied for comparison since FAC had been speculated to be an immature FA. FA and Fibrocystic Changes (FCC) were used for method validation since they have been comprehensively studied. Six common IBC and BBD risk/protective factors were also studied. Co-occurrence analyses were performed using logistic regression models.

Results: Common risk/protective factors were associated with FA, FCC, and IBC in ways consistent with the literature in general, and they were associated with FAC, FA, and FCC in distinct patterns. Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC. We report for the first time that FAC is positively associated with IBC with odds ratio (OR) depending on BMI (OR = 6.78, 95%CI = 3.43-13.42 at BMI<25 kg/m2; OR = 2.13, 95%CI = 1.20-3.80 at BMI>25 kg/m2). This association is only significant with HER2-negative IBC subtypes.

Conclusions: We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA. Co-occurrence analysis can be used for initial assessment of the risk for IBC from a BBD, which is vital to the study of infrequently-reported BBDs.

No MeSH data available.


Related in: MedlinePlus

Determination of the cohort for this study.Abbreviations: CBCP, Clinical Breast Care Project; WR, Walter Reed National Military Medical Center; Malignant NOS, Malignant not otherwise specified.
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pone.0129500.g001: Determination of the cohort for this study.Abbreviations: CBCP, Clinical Breast Care Project; WR, Walter Reed National Military Medical Center; Malignant NOS, Malignant not otherwise specified.

Mentions: This study drew from a pool of patients enrolled in the CBCP from the Walter Reed National Military Medical Center. Patients seen at the CBCP-WR clinic were military beneficiaries referred by a primary care doctor. Conditions resulting in such a referral included, an abnormal mammogram reading, a high risk family history, or other breast-related indications. A Core Questionnaire was completed for every enrolled subject by a nurse case manager, covering demographics, medical history, and risk factor information, etc. For patients undergoing a biopsy/surgery, a Pathology Checklist was completed by the CBCP pathologist to record any of 131 breast pathology lesions observed, including FAC and 78 other BBDs. A diagnosis category was assigned to each patient based on the most severe diagnosis present (i.e., Benign, Atypical, In Situ, Invasive, Other Malignant). CBCP patients enrolled between December 2000 and February 2011, who underwent a biopsy, were identified for this study, and the cohort selection was done as illustrated in Fig 1.


Positive Association of Fibroadenomatoid Change with HER2-Negative Invasive Breast Cancer: A Co-Occurrence Study.

Chen Y, Bekhash A, Kovatich AJ, Hooke JA, Liu J, Kvecher L, Fantacone-Campbell JL, Mitchell EP, Rui H, Mural RJ, Shriver CD, Hu H - PLoS ONE (2015)

Determination of the cohort for this study.Abbreviations: CBCP, Clinical Breast Care Project; WR, Walter Reed National Military Medical Center; Malignant NOS, Malignant not otherwise specified.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4476726&req=5

pone.0129500.g001: Determination of the cohort for this study.Abbreviations: CBCP, Clinical Breast Care Project; WR, Walter Reed National Military Medical Center; Malignant NOS, Malignant not otherwise specified.
Mentions: This study drew from a pool of patients enrolled in the CBCP from the Walter Reed National Military Medical Center. Patients seen at the CBCP-WR clinic were military beneficiaries referred by a primary care doctor. Conditions resulting in such a referral included, an abnormal mammogram reading, a high risk family history, or other breast-related indications. A Core Questionnaire was completed for every enrolled subject by a nurse case manager, covering demographics, medical history, and risk factor information, etc. For patients undergoing a biopsy/surgery, a Pathology Checklist was completed by the CBCP pathologist to record any of 131 breast pathology lesions observed, including FAC and 78 other BBDs. A diagnosis category was assigned to each patient based on the most severe diagnosis present (i.e., Benign, Atypical, In Situ, Invasive, Other Malignant). CBCP patients enrolled between December 2000 and February 2011, who underwent a biopsy, were identified for this study, and the cohort selection was done as illustrated in Fig 1.

Bottom Line: Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC.This association is only significant with HER2-negative IBC subtypes.We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA.

View Article: PubMed Central - PubMed

Affiliation: Biomedical Informatics, Windber Research Institute, Windber, Pennsylvania, United States of America.

ABSTRACT

Background: Risk assessment of a benign breast disease/lesion (BBD) for invasive breast cancer (IBC) is typically done through a longitudinal study. For an infrequently-reported BBD, the shortage of occurrence data alone is a limiting factor to conducting such a study. Here we present an approach based on co-occurrence analysis, to help address this issue. We focus on fibroadenomatoid change (FAC), an under-studied BBD, as our preliminary analysis has suggested its previously unknown significant co-occurrence with IBC.

Methods: A cohort of 1667 female patients enrolled in the Clinical Breast Care Project was identified. A single experienced breast pathologist reviewed all pathology slides for each case and recorded all observed lesions, including FAC. Fibroadenoma (FA) was studied for comparison since FAC had been speculated to be an immature FA. FA and Fibrocystic Changes (FCC) were used for method validation since they have been comprehensively studied. Six common IBC and BBD risk/protective factors were also studied. Co-occurrence analyses were performed using logistic regression models.

Results: Common risk/protective factors were associated with FA, FCC, and IBC in ways consistent with the literature in general, and they were associated with FAC, FA, and FCC in distinct patterns. Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC. We report for the first time that FAC is positively associated with IBC with odds ratio (OR) depending on BMI (OR = 6.78, 95%CI = 3.43-13.42 at BMI<25 kg/m2; OR = 2.13, 95%CI = 1.20-3.80 at BMI>25 kg/m2). This association is only significant with HER2-negative IBC subtypes.

Conclusions: We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA. Co-occurrence analysis can be used for initial assessment of the risk for IBC from a BBD, which is vital to the study of infrequently-reported BBDs.

No MeSH data available.


Related in: MedlinePlus